Cost-effectiveness analysis of pembrolizumab with chemotherapy for metastatic nonsquamous non-small cell lung cancer in Taiwan

被引：0

作者：

Lee, Wei-Ling ^{[1
,2
]}

Chou, Wan-Hsuan ^{[2
]}

Chang, Wei-Pin ^{[3
]}

Chang, Tsung-Wei ^{[4
]}

Kuo, Chun-Nan ^{[2
,5
]}

Chang, Wei-Chiao ^{[2
,5
,6
,7
]}

机构：

[1] Taipei Chang Gung Mem Hosp, Dept Pharm, Taipei, Taiwan

[2] Taipei Med Univ, Coll Pharm, Sch Pharm, Dept Clin Pharm, 250,Wuxing St, Taipei 110, Taiwan

[3] Taipei Med Univ, Coll Management, Sch Hlth Care Adm, Taipei, Taiwan

[4] Yuanlin Christian Hosp, Dept Pharm, Changhua, Taiwan

[5] Taipei Med Univ, Wan Fang Hosp, Dept Pharm, Taipei, Taiwan

[6] Taipei Med Univ, Coll Pharm, Master Program Clin Genom & Prote, Taipei, Taiwan

[7] Taipei Med Univ, Wan Fang Hosp, Integrat Res Ctr Crit Care, Dept Pharm, Taipei, Taiwan

来源：

JOURNAL OF FOOD AND DRUG ANALYSIS | 2024年 / 32卷 / 04期

关键词：

Cost effectiveness analysis; Nonsquamous non-small-cell lung cancer; Pembrolizumab plus chemotherapy; Pharmacoeconomics; Programmed cell death ligand 1; PARTITIONED SURVIVAL; ECONOMIC-EVALUATION; HEALTH-CARE; GUIDELINES; NSCLC; PNEUMONITIS;

D O I：

10.38212/2224-6614.3536

中图分类号：

TS2 [食品工业];

学科分类号：

0832 ;

摘要：

This study was aimed to evaluate the cost-effectiveness of pembrolizumab with chemotherapy (pembrolizumab combination therapy) and compare it with standard-of-care platinum-based chemotherapy (chemotherapy alone) as a fi rst-line treatment for metastatic nonsquamous NSCLC from the perspective of Taiwan's third-party-payer public health-care system. We used a partitioned survival model with an estimated time horizon of 10 years. The partitioned survival model uses Kaplan-Meier estimates of progression-free and overall survival from the KEYNOTE-189 clinical trial. The quality-adjusted life-year (QALY) values were based on utility values by progression status calculated from the KEYNOTE-189 trial. This study examined costs related to treatment regimens, disease management, second-line therapy, end-of-life care, and adverse event management. Cost and utility were discounted at 3% per year. Probabilistic and deterministic sensitivity analyses were performed to test the robustness of the results. The willingness-to-pay threshold was set at 3 pound Taiwan's gross domestic product (GDP), equivalent to NT$2,788,290. In the base-case scenario, pembrolizumab combination therapy resulted in an expected gain of 0.89 QALYs and an incremental cost of NT$2,201,203 relative to chemotherapy alone. The ICER was NT$2,478,601/QALY. In the analysis of the PD-L1 tumor proportion score (TPS) >= 50% subgroup, the patients who received pembrolizumab combination therapy gained 1.12 QALYs more than those who received chemotherapy alone, and the incremental cost was NT$2,522,528. Therefore, the ICER for this subset of patients was NT$2,258,358/QALY. In conclusion, pembrolizumab combination therapy is a cost-effective option for fi rst-line treatment of metastatic nonsquamous NSCLC. The relative cost-effectiveness of pembrolizumab combination therapy is greatest for patients with PD-L1 TPS >= 50%.

引用

页码：568 / 576

页数：10

共 58 条

[1] Taiwan Cancer Registry, (2018)
[2] Alexander M, Kim SY, Cheng H., Update 2020: management of non-small cell lung cancer, Lung, 198, pp. 897-907, (2020)
[3] Lin HT, Liu FC, Wu CY, Kuo CF, Lan WC, Yu HP., Epidemiology and survival outcomes of lung cancer: a population-based study, BioMed Res Int, 2019, (2019)
[4] Niu FY, Zhou Q, Yang JJ, Zhong WZ, Chen ZH, Deng W, Et al., Distribution and prognosis of uncommon metastases from non-small cell lung cancer, BMC Cancer, 16, (2016)
[5] Kuo CN, Liao YM, Kuo LN, Tsai HJ, Chang WC, Yen Y., Cancers in Taiwan: Practical insight from epidemiology, treatments, biomarkers, and cost, J Formos Med Assoc, 119, pp. 1731-1741, (2020)
[6] Garon EB, Hellmann MD, Rizvi NA, Carcereny E, Leighl NB, Ahn MJ, Et al., Five-year overall survival for patients with advanced non‒small-cell lung cancer treated with pembrolizumab: results from the phase I KEYNOTE-001 study, J Clin Oncol, 37, pp. 2518-2527, (2019)
[7] Hendriks LE, Kerr KM, Menis J, Mok TS, Nestle U, Passaro A, Et al., Non-oncogene-addicted metastatic non-small-cell lung cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up, Ann Oncol, 34, pp. 358-376, (2023)
[8] Qu J, Wang L, Jiang M, Zhao D, Wang Y, Zhang F, Et al., A review about pembrolizumab in first-line treatment of advanced NSCLC: focus on KEYNOTE studies, Cancer Manag Res, 12, pp. 6493-6509, (2020)
[9] Qin Q, Li B., Pembrolizumab for the treatment of nonsmall cell lung cancer: current status and future directions, J Cancer Res Therapeut, 15, pp. 743-750, (2019)
[10] Pai-Scherf L, Blumenthal GM, Li H, Subramaniam S, Mishra-Kalyani PS, He K, Et al., FDA approval summary: pembrolizumab for treatment of metastatic non-small cell lung cancer: first-line therapy and beyond, Oncol, 22, pp. 1392-1399, (2017)

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