The impact of government reimbursement negotiation on targeted anticancer medicines use and cost in China: A cohort study based on national health insurance data

Yang, Yu; Zhang, Yichen; Wagner, Anita K.; Li, Huangqianyu; Shi, Luwen; Guan, Xiaodong

doi:10.7189/jogh.13.04083

Cited by 1 publication

(2 citation statements)

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“…In recent years, China has witnessed a dedicated endeavour to enhance the availability and affordability of innovative cancer medications. 56 The National Medical Products Administration has introduced numerous favourable policies to accelerate the development, review and approval of promising anti-cancer drugs. 57 Based on rigorous cost-effectiveness and budget impact analyses, an increasing number of innovative medicines were successfully incorporated into the NRDL through meticulous price negotiations.…”

Section: Discussionmentioning

confidence: 99%

“… 15 Drug prices have been reduced by half. 56 Camrelizumab, sintilimab and tislelizumab produced more favourable cost-effectiveness primarily attributed to price-negotiation mechanisms. 15 Considering imported PD-1 inhibitors, previous studies have shown that nivolumab and pembrolizumab might not exhibit cost-effectiveness relative to chemotherapy as second-line treatments for advanced OSCC patients from the perspective of Chinese society, aligning analogously to the findings of the current study.…”

Section: Discussionmentioning

confidence: 99%

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Immune checkpoint inhibitors versus chemotherapy as second-line therapy for advanced oesophageal squamous cell carcinoma: a systematic review and economic evaluation

Liu,

Dou,

2024

Therap Adv Gastroenterol

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Background: Recently, several novel programmed cell death protein 1 (PD-1) inhibitors have been approved for second-line treating advanced or metastatic oesophageal squamous cell carcinoma (OSCC), including camrelizumab, nivolumab, pembrolizumab, sintilimab and tislelizumab. However, the optimal treatment regimen remained ambiguous. Objectives: The purpose of this study was to investigate the efficacy, safety and economy of available PD-1 inhibitors to determine the optimal treatment from the Chinese healthcare system perspective. Design: A systematic review and economic evaluation. Data sources and methods: A systematic review was undertaken utilizing PubMed, Web of Science, Cochrane Library, Embase and Scopus databases to identify eligible studies until 31 August 2023. Primary outcomes were progression-free survival (PFS), overall survival (OS) and adverse events (AEs). We also developed a partitioned survival model at 3-week intervals based on five clinical trials to predict long-term costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios for various treatment options. Direct medical costs and utility values were obtained from public drug bidding databases, clinical trials or published literature. The parameter uncertainties within the model were determined via one-way and probabilistic sensitivity analyses. Results: Five randomized controlled trials involving 2837 patients were included in the analysis. Compared with other treatments examined, camrelizumab provided the best PFS benefits [hazard ratio (HR): 0.69, 95% confidence interval (CI): 0.56–0.86], and pembrolizumab provided the best OS benefits (HR: 0.55, 95% CI: 0.37–0.82). Nivolumab caused a relatively lower incidence of treatment-related AEs (HR: 0.10, 95% CI: 0.05–0.20) and grade 3–5 AEs (HR: 0.13, 95% CI: 0.08–0.21) than other immunotherapy regimens. In the economic evaluation, average 10-year costs ranged from $5,433.86 (chemotherapy) to $50,617.95 (nivolumab) and mean QALYs ranged from 0.55 (chemotherapy) to 0.82 (camrelizumab). Pembrolizumab was eliminated because of dominance. Of the remaining strategies, when the willingness-to-pay thresholds were 1, 2 and 3 times GDP per capita in 2022, sintilimab, tislelizumab and camrelizumab were the most cost-effective treatment options, respectively. Conclusion: Sintilimab might be the optimal treatment alternative for second-line therapy of advanced OSCC in China, followed by tislelizumab and camrelizumab. Trial registration: This study has been registered on the PROSPERO database with the registration number CRD42023495204.

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Section: Discussionmentioning

confidence: 99%