Cost-effectiveness of pembrolizumab versus chemotherapy in patients with platinum-pretreated, recurrent or metastatic nasopharyngeal cancer.

IF 1.7 4区医学 Q3 HEALTH POLICY & SERVICES Cost Effectiveness and Resource Allocation Pub Date : 2024-01-24 DOI:10.1186/s12962-024-00515-6

Jing Nie, Huina Wu, Qian Wu, Lihui Liu, Ke Tang, Shuo Wang, Jiyong Wu

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Abstract

Background: Programmed cell death protein 1 (PD-1) monoclonal antibody, pembrolizumab, is a promising drug for platinum-pretreated, recurrent or metastatic nasopharyngeal cancer (NPC). We aimed to assess the cost-effectiveness of pembrolizumab compared with chemotherapy for Chinese patients in this NPC.

Methods: The cost-effectiveness of pembrolizumab versus chemotherapy was evaluated using a partitioned survival model with a 5-year boundary. Efficacy and toxicity data were derived from the KEYNOTE-122 trials. Economic indicators including life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER), and lifetime cost were used. One-way analysis and probabilistic sensitivity analysis (PSA) were performed to explore the uncertainties. Additionally, various scenario analyses, including different pembrolizumab price calculations and discount rates were performed.

Results: Pembrolizumab or chemotherapy alone respectively yielded 2.82 QALYs (3.96 LYs) and 2.73 QALYs (3.93 LYs) with an ICER of $422,535 per QALYs ($1,232,547 per LYs). This model was primarily influenced by the price of pembrolizumab. Furthermore, PSA indicated that pembrolizumab had none probability of being cost-effective compared with chemotherapy at a willingness-to- pay (WTP) of $38223. Scenario analyses revealed that irrespective of any potential price reduction or adjustments in the discount rate, no discernible impact on the ultimate outcome was observed.

Conclusion: Pembrolizumab was less cost-effective for patients with platinum-pretreated, recurrent or metastatic NPC compared with chemotherapy in China.

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在铂类药物治疗的复发或转移性鼻咽癌患者中，pembrolizumab 与化疗的成本效益对比。

背景：程序性细胞死亡蛋白1（PD-1）单克隆抗体--pembrolizumab是一种治疗铂类药物治疗的复发性或转移性鼻咽癌（NPC）的有前途的药物。我们旨在评估中国鼻咽癌患者使用 pembrolizumab 与化疗相比的成本效益：方法：使用以 5 年为界的分区生存模型评估了 pembrolizumab 与化疗的成本效益。疗效和毒性数据来自 KEYNOTE-122 试验。经济指标包括生命年（LYs）、质量调整生命年（QALYs）、增量成本效益比（ICER）和终生成本。为探讨不确定性，进行了单向分析和概率敏感性分析（PSA）。此外，还进行了各种情景分析，包括不同的 Pembrolizumab 价格计算和贴现率：单用 Pembrolizumab 或化疗分别可获得 2.82 QALYs（3.96 LYs）和 2.73 QALYs（3.93 LYs），每 QALYs 的 ICER 为 422,535 美元（每 LYs 为 1,232,547 美元）。该模型主要受彭布利珠单抗价格的影响。此外，PSA 显示，在支付意愿（WTP）为 38223 美元时，与化疗相比，pembrolizumab 没有成本效益的可能性。情景分析表明，无论是否可能降价或调整贴现率，都不会对最终结果产生明显影响：在中国，与化疗相比，Pembrolizumab 治疗铂类药物治疗的复发性或转移性鼻咽癌患者的成本效益较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cost Effectiveness and Resource Allocation HEALTH POLICY & SERVICES-

CiteScore

3.40

自引率

4.30%

发文量

审稿时长

34 weeks

期刊介绍： Cost Effectiveness and Resource Allocation is an Open Access, peer-reviewed, online journal that considers manuscripts on all aspects of cost-effectiveness analysis, including conceptual or methodological work, economic evaluations, and policy analysis related to resource allocation at a national or international level. Cost Effectiveness and Resource Allocation is aimed at health economists, health services researchers, and policy-makers with an interest in enhancing the flow and transfer of knowledge relating to efficiency in the health sector. Manuscripts are encouraged from researchers based in low- and middle-income countries, with a view to increasing the international economic evidence base for health.