Cost-effectiveness analysis of trilaciclib for preventing myelosuppression in small cell lung cancer patients treated with etoposide, carboplatin, and atezolizumab.

Abstract

This study evaluated the economic value of administering trilaciclib to prevent myelosuppression in extensive-stage small cell lung cancer (ES-SCLC) patients receiving etoposide, carboplatin, and atezolizumab (E/P/A) from both the Chinese and the United States (US) perspectives. A decision tree model was constructed to estimate and compare costs, quality-adjusted life years (QALYs), incremental cost-effectiveness ratios (ICERs), incremental net health benefits (INHBs), and incremental net monetary benefits (INMBs). One-way and probabilistic sensitivity analyses were conducted to assess the robustness and uncertainty of the economic analysis. The base case analysis indicated that from the perspective of US payers, trilaciclib was cost-saving at the WTP threshold of $241,230.00, with an incremental cost of $-12,626.08, an INMB of $16,788.02, and an INHB of 0.07 QALYs. Conversely, from the perspective of Chinese payers, the use of trilaciclib was not economical at the WTP threshold of $35,817.44, with an ICER of $691,541.63/QALY, an INMB of -$8,765.52, and an INHB of -0.24 QALYs. Sensitivity analysis confirmed the stability of these results. Probabilistic sensitivity analysis indicated that, from the Chinese payers' perspective, trilaciclib treatment was not economical, with a probability of 100%. In contrast, from the US payers' perspective, it was economical, with a probability of 90.05%. Given the limited clinical data available for trilaciclib in the Chinese population, the cost-effectiveness of trilaciclib may improve with the inclusion of new data or changes in health insurance policies.