Cost-effectiveness analysis of pembrolizumab in first-line treatment of patients with unresectable or metastatic MSI-H/dMMR colorectal cancer
AIM To evaluate the economics of pembrolizumab in the first-line treatment of patients with unresectable or metastatic microsatellite instability-high/mismatch repair-deficient(MSI-H/dMMR)colorectal cancer.METHODS Based on the Chinese healthcare system,a partitioned survival model was constructed to compare the cost and utility between pembrolizumab and standard of care using KEYNOTE-177 clinical trial data.The cycle length and time horizon of the model was set as 21 days and 10 years,respectively.The incremental cost-effectiveness ratio(ICER)was used as the evaluation indicator.Scenario analysis and sensitivity analysis were also performed.RESULTS Compared with standard of care,the ICER of pembrolizumab was 221 546.85 yuan·QALY-1,which was lower than 3 times China's per capita gross domestic product(GDP)in 2021.The pembrolizumab was dominant when patient assistance program was considered.The results of one-way sensitivity analysis showed that the proportion of pembrolizumab on subsequent treatment in the standard of care,pembrolizumab price and discounting exhibited the significant impact on the ICER.The results of probability sensitivity analysis showed that under the 3 times China's per capita GDP in 2021,the probability of pembrolizumab being cost-effectiveness was 63.36％.CONCLUSION Pembrolizumab has a cost-effective advantage over standard of care as first-line treatment for unresectable or metastatic MSI-H/dMMR colorectal cancer in China.
pembrolizumabcolorectal neoplasmsmicrosatellite instabilitycost-utility analysispartitioned survival model
万方数据
维普
