Cost-utility analysis of serplulimab combined with chemotherapy in the first-line treatment of PD-L1(CPS≥1)locally advanced or metastatic esophageal squamous cell carcinoma
OBJECTIVE To evaluate the economics of serplulimab combined with chemotherapy versus chemotherapy alone in the first-line treatment of locally advanced or metastatic esophageal squamous cell carcinoma with PD-L1 combined positive score(CPS)≥1 from the perspective of China's health system.METHODS Based on the ASTRUM-007 study,a three-state partitioned survival model was developed for cost-utility analysis,and the cycle was 2 weeks,the simulated time limit was patient lifetime,and the discount rate was 5％.The incremental cost-effectiveness ratio(ICER)was used as an indicator to evaluate the economics of serplulimab combined with chemotherapy compared with chemotherapy alone,and sensitivity analysis was per-formed on the results.RESULTS The results of cost-utility analysis showed that the ICER of serplulimab combined with chemo-therapy compared with chemotherapy alone was 914 665.82 yuan/QALY,which was higher than 3-fold per capita GDP in China in 2022.The results of sensitivity analysis showed that the factors significantly affecting the results were the cost of serplulimab,the PFS state utility value,PD state utility value and discount rate;in the willingness to pay(WTP)threshold was three times China's per capita GDP in 2022,the economic probability of serplulimab combined with chemotherapy was 0.CONCLUSION Using 3 times China's per capita GDP in 2022 as the WTP threshold,serplulimab combined with chemotherapy is not economical compared with chemotherapy alone in the first-line treatment of PD-L1(CPS ≥ 1)locally advanced or metastatic esophageal squamous cell carcinoma.
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