Pembrolizumab combined with chemotherapy versus placebo combined with chemotherapy for HER2-negative advanced gastric cancer in China: a cost-effectiveness analysis.

IF 1.8 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2024-10-01 Epub Date: 2024-07-12 DOI:10.1080/14737167.2024.2378986

Zhiwei Zheng, Xiaobing Song, Hongfu Cai, Huide Zhu

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Abstract

Objective: This study aims to conduct a cost-effectiveness analysis of pembrolizumab in combination with chemotherapy for HER2-negative advanced gastric cancer in China.

Methods: A partitioned survival approach model was constructed to simulate the progression of HER2-negative advanced gastric cancer and evaluate the outcomes of different treatment strategies. We calculated incremental cost-effectiveness ratios (ICER) to assess the cost associated with each quality-adjusted life-year (QALY) gained. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to assess robustness and reliability.

Results: The analysis conducted in the base case demonstrated that the ICER associated with pembrolizumab was $177405.83/QALY gained in all population. In the subgroup analysis, it was found that individuals with a PD-L1 CPS ≥ 1 and those with a PD-L1 CPS ≥ 10 had ICERs of $152397.06/QALY and $109534.13/QALY, respectively. All ICER values for both the all population groups and the subgroups exceeded the WTP threshold in China. Our analysis shows the robustness of these results, as they remained consistent when input parameters were varied within a ± 25% range.

Conclusion: The findings of this cost-effectiveness analysis suggest that pembrolizumab in combination with chemotherapy is not a cost-effective treatment option for HER2-negative advanced gastric cancer in China.

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中国HER2阴性晚期胃癌患者Pembrolizumab联合化疗与安慰剂联合化疗的成本效益分析。

研究目的本研究旨在对Pembrolizumab联合化疗治疗中国HER2阴性晚期胃癌进行成本效益分析：方法：建立分区生存法模型，模拟HER2阴性晚期胃癌的进展过程，评估不同治疗策略的效果。我们计算了增量成本效益比（ICER），以评估每获得一个质量调整生命年（QALY）的相关成本。为了评估稳健性和可靠性，我们进行了单向敏感性分析和概率敏感性分析：基础病例分析表明，在所有人群中，与彭博利珠单抗相关的 ICER 为 177405.83 美元/QALY。在亚组分析中发现，PD-L1 CPS≥1和PD-L1 CPS≥10的个体的ICER分别为152397.06美元/QALY和109534.13美元/QALY。在中国，所有人群组和亚人群组的 ICER 值均超过了 WTP 临界值。我们的分析表明了这些结果的稳健性，因为当输入参数在 ± 25% 的范围内变化时，这些结果仍然保持一致：本成本效益分析结果表明，在中国，Pembrolizumab联合化疗治疗HER2阴性晚期胃癌并不具有成本效益。

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

Expert Review of Pharmacoeconomics & Outcomes Research HEALTH CARE SCIENCES & SERVICES-PHARMACOLOGY & PHARMACY

CiteScore

4.00

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Expert Review of Pharmacoeconomics & Outcomes Research (ISSN 1473-7167) provides expert reviews on cost-benefit and pharmacoeconomic issues relating to the clinical use of drugs and therapeutic approaches. Coverage includes pharmacoeconomics and quality-of-life research, therapeutic outcomes, evidence-based medicine and cost-benefit research. All articles are subject to rigorous peer-review. The journal adopts the unique Expert Review article format, offering a complete overview of current thinking in a key technology area, research or clinical practice, augmented by the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.