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Cost-effectiveness of domestic PD-1 inhibitor Camrelizumab combined with chemotherapy in the first-line treatment of advanced nonsquamous non–small-cell lung cancer in China

Citation

Qiao, L and Zhou, Z and Zeng, X and Tan, C, Cost-effectiveness of domestic PD-1 inhibitor Camrelizumab combined with chemotherapy in the first-line treatment of advanced nonsquamous non-small-cell lung cancer in China, Frontiers in Pharmacology pp. 1-8. ISSN 1663-9812 (2021) [Refereed Article]


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DOI: doi:10.3389/fphar.2021.728440

Abstract

Objective: Camrelizumab is the first domestic PD-1inhibitor approved to be combined with chemotherapy as a first-line therapy for advanced nonsquamous non–small-cell lung cancer (NSCLC) in China. The purpose of this study was to determine whether using camrelizumab in the first-line setting is cost-effective in China when compared with traditional chemotherapy or the imported PD-1inhibitor pembrolizumab.

Material and Methods: A Markov model was built to simulate 3-week patient transitions over a 30-year horizon from the perspective of the Chinese healthcare system. Health states included stable disease, first progression, second progression, and death. A direct comparison between first-line camrelizumab in combination with pemetrexed and carboplatin (CPC) and pemetrexed plus carboplatin (PC) was performed by calculating transition probabilities from the CameL trial. An indirect comparison between first-line CPC and pembrolizumab in combination with pemetrexed and platinum (PPP) was performed by calculating transition probabilities using a network meta-analysis. Costs in the Chinese setting were collected from the local public database and literatures. Sensitivity analyses explored the uncertainty around model parameters.

Results: In the primary analysis, first-line CPC gained an additional 0.41 quality-adjusted life-years (QALYs) with an incremental cost of $3,486 compared with PC, resulting in an incremental cost-effectiveness ratio (ICER) of $8,378 per QALY gained. In the secondary analysis, first-line PPP yielded an additional 0.10 QALYs at an incremental cost of $6,710, resulting in an ICER of $65,563 per QALY gained.

Conclusion: For Chinese patients with advanced nonsquamous NSCLC without targetable genetic aberrations, our primary analysis results supported first-line CPC as a cost-effective treatment compared with traditional PC chemotherapy. The findings of our secondary analysis suggested that first-line PPP would not be a cost-effective option compared with first-line CPC. This analysis provided strong evidence for promoting the widespread use of first-line CPC in China and, to some extent, stimulated the enthusiasm for the development of domestic cancer drugs.

Item Details

Item Type:Refereed Article
Keywords:cost-effectiveness, nonsquamous non–small-cell lung cancer, camrelizumab, pembrolizumab, pemetrexed, China
Research Division:Economics
Research Group:Econometrics
Research Field:Economic models and forecasting
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Zhou, Z (Dr Zhen Zhou)
ID Code:147464
Year Published:2021
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-11-02
Last Modified:2021-11-02
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