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Archive > Volume 30 Issue 2 > 2023,30(2):150-155. DOI:10.3872/j.issn.1007-385X.2023.02.008 Prev Next
Clinical Research
Cost-effectiveness analysis of multiple first-line PD-1 inhibitors immunotherapy strategies for advanced esophageal squamous cell carcinoma
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Abstract:
Objective: To determine the cost-effectiveness of adding PD-1 inhibitors to standard chemotherapy as the first-line treatment in patients with advanced, relapsed or metastatic esophageal squamous cell carcinoma (ESCC). Methods: Based on four first-line phase Ⅲ clinical trials of advanced ESCC: JUPITER-06, ESCORT-1st, ORIENT-15 and KEYNOTE-590 studies, Treeage Pro 2011 was used to establish traditional Markov model. The Markov model included three states: progression-free survival (PFS), progressive disease (PD) and death. Health outcomes were measured in quality-adjusted life years (QALYs) and incremental cost effectiveness ratio (ICER) was used to evaluate the economic benefits of treatment strategies. The sensitivity analysis was employed to further validate the above listed results. Results: The total cost of toripalizumab-chemotherapy group, camrelizumab-chemotherapy group, sintilimab-chemotherapy group, pembrolizumab-chemotherapy group and placebo-chemotherapy group were 66 327.58, 63 473.64, 62 268.18,295 515.26, and 32 753.79 yuan, respectively. The utility values were 0.648, 0.605, 0.673, 0.585, and 0.536 QALY, respectively. Among them, the ICER value of sintilimab-chemotherapy group was 217 018.13 yuan/QALY, which was lower than the Chinese willingness-to-pay (WTP) threshold (242 928 yuan/QALY), and it was a comparatively acceptable treatment strategy. Sensitivity analysis showed that the discount rate and the cost of sintilimab had the greatest influence on the model. Conclusion: Under the current economic situation in China, sintilimab combined with chemotherapy is an acceptable first-line PD-1 inhibitors immunotherapy strategy for the treatment of advanced ESCC.
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