Cost-utility analysis of sugemalimab combined with chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma with high PD-L1 expression
- VernacularTitle:舒格利单抗联合化疗方案一线治疗PD-L1高表达晚期食管鳞状细胞癌的成本-效用分析
- Author:
Qiuping CHEN
1
;
Quan SUN
2
;
Zhengnan SHEN
3
;
Congying TANG
3
;
Jibin LIU
3
;
Baixue LI
3
Author Information
1. Dept. of Infectious Disease，College of Clinical Medicine，Chengdu University of TCM，Chengdu 610075，China
2. Hainan Zhongwei Institute of Health Economy Development，Haikou 570106，China
3. College of Basic Medicine，Chengdu University of TCM，Chengdu 611130，China
- Publication Type:Journal Article
- Keywords:
sugemalimab;
esophageal squamous cell carcinoma;
high PD-L1 expression;
cost-utility analysis;
partitioned
- From:
China Pharmacy
2024;35(23):2896-2902
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To evaluate the cost-effectiveness of the first-line treatment using the combination therapy of sugemalimab and chemotherapy （hereinafter referred to as the “combination therapy”） for advanced esophageal squamous cell carcinoma （ESCC） with high programmed death-ligand 1 （PD-L1） expression from the perspective of the Chinese healthcare system. METHODS A partitioned survival model was constructed based on data from the GEMSTONE-304 study. The model cycle was set at 3 weeks， with a study duration of 10 years and a discount rate of 5%. The primary output parameters of the model included total costs， quality-adjusted life year （QALY）， incremental costs， and incremental cost-effectiveness ratio （ICER）. Cost- utility analysis was employed to assess the economic feasibility of the combination therapy compared to chemotherapy alone. The robustness of the base case analysis results was evaluated through univariate sensitivity analysis， probabilistic sensitivity analysis， and scenario analysis. RESULTS The ICER of the combination therapy compared to chemotherapy alone was 288 430.35 yuan/QALY， significantly exceeding the willingness-to-pay （WTP） threshold of 173 354.52 yuan/QALY which was set at 1.94 times the per capita gross domestic product （GDP） in 2023. The price of sugemalimab was the primary factor influencing the ICER. When the WTP threshold was set at 1.94 times the per capita GDP （173 354.52 yuan/QALY）， the probability of the combination therapy being cost-effective compared to chemotherapy alone was 0. The combination therapy only became cost-effective compared to chemotherapy alone when the price of the drug dropped to 6 107.41 yuan per box （600 mg）. CONCLUSIONS From the perspective of the Chinese healthcare system， the combination therapy for first-line treatment of advanced ESCC with high PD-L1 expression is not cost-effective； the combination therapy is cost-effective when the price of sugemalimab decreas by 50.65%.
