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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


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, 12 pp. 1-8. ISSN 1663-9812 (2021) [Refereed Article]

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Copyright Statement

Copyright © 2021 Qiao, Zhou, Zeng and Tan. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License ( The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

DOI: doi:10.3389/fphar.2021.728440


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
Web of Science® Times Cited:3
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-11-02
Last Modified:2021-12-23
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