Serplulimab plus chemotherapy as first-line treatment for extensive-stage small-cell lung cancer: A cost-effectiveness analysis

Ying, Zhu; Liu, Kun; Qin, Qian; Zhu, Hong

doi:10.3389/fimmu.2022.1044678

Cited by 21 publications

(26 citation statements)

References 36 publications

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“…Due to the considerable price advantage and accessibility, sintilimab and camrelizumab plus chemotherapy may be appropriate alternatives for advanced ESCC patients. Serplulimab, a novel domestic PD-1 inhibitor, plus chemotherapy for first-line treatment has not shown an economic advantage, although it may be cost-effective in patients with extensive-stage small cell lung cancer (Zhu et al, 2022b). Therefore, a substantial price reduction for serplulimab was essential to improve patient affordability.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of PD-1 inhibitors combined with chemotherapy as first-line therapy for advanced esophageal squamous-cell carcinoma in China

Liu

Dou²,

Li³

2023

Front. Pharmacol.

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Objective: This study was aimed to investigate the cost-effectiveness of all available programmed death 1 (PD-1) inhibitors combined with chemotherapy in the first-line treatment of advanced esophageal squamous-cell carcinoma (ESCC) from the Chinese healthcare system perspective.Methods: A partitioned survival model with a 3-week cycle and a 10-year time horizon was constructed based on a network meta-analysis. The survival data and utility values were derived from clinical trials, and the direct medical costs were collected from public drug bidding database and published literature. Total costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs) were calculated. Scenario, one-way and probabilistic sensitivity analyses were performed to assess the uncertainty around model parameters.Results: Compared with mono-chemotherapy, toripalimab, sintilimab and camrelizumab plus chemotherapy were cost-effective treatment regimens, while serplulimab, pembrolizumab and nivolumab plus chemotherapy were not cost-effective options. Toripalimab plus chemotherapy provided the highest QALYs of 0.95 with the lower cost of $8,110.53 compared to other competing alternatives. The robustness of the base-case results was confirmed by scenario and one-way sensitivity analysis. At a willingness-to-pay threshold of three times per capita gross domestic product ($38,351.20) in 2021, the probability of toripalimab plus chemotherapy being the optimal option was 74.25% compared with other six competing alternatives.Conclusion: Toripalimab plus chemotherapy represented the most cost-effective option as the first-line therapy for advanced ESCC patients in China.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of PD-1 inhibitors combined with chemotherapy as first-line therapy for advanced esophageal squamous-cell carcinoma in China

Liu

Dou²,

Li³

2023

Front. Pharmacol.

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“…Several cost‐effectiveness analyses have been performed, 30–33 and most of them showed that the addition of immunotherapy to chemotherapy is not cost‐effective for SCLC patients. One exception is the addition of serplulimab to chemotherapy, which was shown to be cost‐effective in a recent analysis 34 …”

Section: Discussionmentioning

confidence: 99%

Safety evaluation of immune checkpoint inhibitors combined with chemotherapy for the treatment of small cell lung cancer: A meta‐analysis of randomized controlled trials

et al. 2023

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Background The addition of immune checkpoint inhibitors (ICIs) to chemotherapy is the new standard of care in the first‐line treatment of small cell lung cancer (SCLC). However, although the concomitant use of immunotherapy and chemotherapy can increase the antitumor efficacy, it can also increase toxicity. The present study evaluated the tolerability of immune‐based combinations in the first‐line treatment of SCLC. Methods Relevant trials were identified by searching electronic databases and conference meetings. Seven phase II and III randomized controlled trials and 3766 SCLC patients were included in the meta‐analysis (immune‐based combinations = 2133; chemotherapy = 1633). Outcomes of interest included treatment‐related adverse events (TRAEs) and the rate of discontinuation due to TRAEs. Results Immune‐based combination treatment was associated with a higher risk of grade 3–5 TRAEs (odds ratio [OR], 1.16; 95% confidence interval [CI]: 1.01–1.35). Immune‐based combinations were associated with a higher risk of TRAEs leading to discontinuation (OR, 2.30; 95% CI: 1.17–4.54). No differences were observed in grade 5 TRAEs (OR, 1.56; 95% CI: 0.93–2.63). Conclusion This meta‐analysis indicates that the addition of immunotherapy to chemotherapy in SCLC patients is associated with a higher risk of toxicity and probably of treatment discontinuation. Tools for identifying SCLC patients that would not benefit from immune‐based therapy are urgently needed.

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“…17,18 A frequency network meta-analysis was then selected to perform indirect comparisons, with HR values associated with the durvalumab plus GemCis versus pembrolizumab plus GemCis regimens (.92 [.73-1.15] and .86 [.69-1.07]) (Table 1) being derived using a fixed-effects meta-regression model (Table 1). [18][19][20] Model construction, data extraction and parameter calculations were respectively performed with TreeAge Pro 2022, GetData Graph Digitizer (v 2.26) and the 'netmeta' package in Rstudio (v 1.2.5042).…”

Section: Model Structure and Survivalmentioning

confidence: 99%

“…22 Grade 3 or higher treatment-associated adverse events (AEs) were assigned a mean disutility value of .073 as a means of assessing deteriorating patient QoL (Table 1). [17][18][19][22][23][24][25] The present study considered direct costs, including the costs of drugs, administration, laboratory testing, imaging, grade 3 or higher AE management (for AEs with ≥5% incidence), BSC and terminal care (Table 1). Real-world hospital data and information from the Centers for Medicare & Medicaid Services were used to determine drug costs.…”

Section: Utilities and Costsmentioning

confidence: 99%

“…26 While other direct medical costs were derived from prior publications. [17][18][19]22,25,27 Costs were adjusted for inflation to 2023 prices based on the USA consumer price index (CPI). 28 No inflation adjustments were performed for drug pricing in China, as the Chinese government regulates healthcare costs and ensures that they remain stable.…”

Section: Utilities and Costsmentioning

confidence: 99%

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Immune checkpoint inhibitor for patients with advanced biliary tract cancer: A cost‐effectiveness analysis

Zhu,

Liu,

Zhu

2023

Liver International

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Background and AimsThe increasingly widespread of immune checkpoint inhibitors (ICIs) in the field of antitumors has brought a new dawn for patients with advanced biliary tract cancer (aBTC). However, the choice of treatment needs to be supported by economic evaluation. Therefore, the cost‐effectiveness comparison of first‐line durvalumab or pembrolizumab plus gemcitabine and cisplatin (GemCis) treatment of aBTC was explored from the perspective of American and Chinese healthcare systems.MethodsGround on the TOPAZ‐1 and KEYNOTE‐966 trials, the Markov model with a 15‐year horizon including three health states to imitate cost and effective outcomes was established. Incremental cost‐effectiveness ratio (ICER) at willingness‐to‐pay (WTP) thresholds of $100 000/QALY and $37 408/ALY in the USA and China was used as the most important indicator. Other endpoint indexes included total cost, life years (LYs), quality‐adjusted life years (QALYs) and incremental net‐health benefit (INHB). To verify the robustness, sensitivity and subgroup analyses were performed.ResultsDurvalumab plus GemCis ($322 211 [2.94 QALYs] and $35 695 [2.76 QALYs]) increased cost (effectiveness) by $63 777 (.22 QALYs) and $5234 (.20 QALYs) than pembrolizumab plus GemCis ($258 434 [2.72 QALYs] and $30 461 [2.56 QALYs]) in the USA and China, respectively. The corresponding ICER was $288 725/QALY and $26 401/QALY, with INHB of −.42 and .06 QALYs, respectively. The cost of ICIs was the most important factor influencing results.ConclusionsIn China, first‐line durvalumab plus GemCis versus pembrolizumab plus GemCis was a cost‐effective option for patients with aBTC, but not in the USA.

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Serplulimab plus chemotherapy as first-line treatment for extensive-stage small-cell lung cancer: A cost-effectiveness analysis

Cited by 21 publications

References 36 publications

Cost-effectiveness analysis of PD-1 inhibitors combined with chemotherapy as first-line therapy for advanced esophageal squamous-cell carcinoma in China

Cost-effectiveness analysis of PD-1 inhibitors combined with chemotherapy as first-line therapy for advanced esophageal squamous-cell carcinoma in China

Safety evaluation of immune checkpoint inhibitors combined with chemotherapy for the treatment of small cell lung cancer: A meta‐analysis of randomized controlled trials

Immune checkpoint inhibitor for patients with advanced biliary tract cancer: A cost‐effectiveness analysis

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