Sintilimab Plus Bevacizumab Biosimilar Versus Sorafenib as First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Cost-Effectiveness Analysis

Abstract

Objective: The ORIENT-32 clinical trial revealed that sintilimab plus bevacizumab biosimilar significantly improved the median progression-free survival and median overall survival (OS) compared with sorafenib. This analysis evaluated the cost-effectiveness of sintilimab plus bevacizumab biosimilar as a first-line treatment for unresectable hepatocellular carcinoma from the Chinese perspective of healthcare system.Materials and methods: A Markov model with three mutual health states was constructed to evaluate the economic outcome of sintilimab plus bevacizumab biosimilar. The model cycle was 21 days, and the simulation time horizon was a lifetime. The output parameters of the model were the total cost, life-year (LY), quality-adjusted LY (QALY), and incremental cost-effectiveness ratio (ICER). Sensitivity analyses were conducted to assess the robustness of the results.Results: The base-case results found that sintilimab plus bevacizumab biosimilar provided an improvement of 1.27 QALYs and 1.84 LYs compared with sorafenib, and the ICER was $23,352/QALY. The hazard ratio for OS had the greatest influence on the ICER. The probability of sintilimab plus bevacizumab biosimilar was 85% at willingness-to-pay thresholds of $30,552/QALY.Conclusion: The findings of this analysis suggested that sintilimab plus bevacizumab biosimilar was a cost-effective first-line therapy for patients with unresectable hepatocellular carcinoma.

Cost-effectiveness of sintilimab plus bevacizumab biosimilar versus sorafenib for unresectable hepatocellular carcinoma

“…The result of probabilistic sensitivity analysis showed our nding is generally robust. Recently, Peng et al reported the sintilimab plus IBI305 was cost-effective versus sorafenib among patients in China [22]. Although we used different model and local-speci c cost, similar results were obtained by using a partitioned survival model in this study.…”

Cost-Effectiveness Analysis of Sintilimab Combined with Chemotherapy Versus Chemotherapy Alone as the First-Line Treatment for Advanced Esophageal Cancer

“…Previous studies have analyzed the economic benefits of sintilimab combined with chemotherapy compared with chemotherapy alone as the first-line treatment of unresectable hepatocellular carcinoma, locally advanced or metastatic non-squamous ( Peng et al, 2022 ; Rui et al, 2022 ). The economic evaluation of sintilimab as the primary treatment for advanced esophageal cancer was lacking.…”

“…Despite the encouraging clinical performance, the high treatment cost of sintilimab has been under the spotlight. Current cost-effective analyses of sintilimab are mostly conducted for hepatocellular carcinoma and non-small-cell lung carcinoma ( Peng et al, 2022 ; Zhou et al, 2022 ; Zhu et al, 2022 ). Studies on the cost-effectiveness of sintilimab combined with chemotherapy as the first-line treatment for esophageal carcinoma need to be conducted.…”

Cost-effectiveness analysis of sintilimab plus chemotherapy for advanced or metastatic esophageal squamous cell carcinoma

“…A few pharmacoeconomic evaluations were conducted on sintilimab, with only three studies retrieved in PubMed, but their economic results were all cost-effective, which is consistent with our findings. Two economic studies using clinical data from the ORIENT-32 trial (26) demonstrated that compared with sorafenib, sintilimab plus bevacizumab may provide a costeffective treatment for Chinese patients with unresectable hepatocellular carcinoma (14,27). Rui et al reported that sintilimab plus chemotherapy as a first-line therapeutic option for nonsquamous non-small-cell lung cancer of locally advanced or metastatic was more cost-effective in China in comparison with karilizumab plus chemotherapy (28).…”

“…A few pharmacoeconomic evaluations were conducted on sintilimab, with only three studies retrieved in PubMed, but their economic results were all cost-effective, which is consistent with our findings. Two economic studies using clinical data from the ORIENT-32 trial ( 26 ) demonstrated that compared with sorafenib, sintilimab plus bevacizumab may provide a cost-effective treatment for Chinese patients with unresectable hepatocellular carcinoma ( 14 , 27 ). Rui et al.…”