Cost-utility analysis of sugemalimab combined with chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma with high PD-L1 expression
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 288430.35 yuan/QALY,significantly exceeding the willingness-to-pay (WTP) threshold of 173354.52 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 (173354.52 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 6107.41 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％.
万方数据
维普
