Cost-Effectiveness Analysis of Durvalumab Plus Chemotherapy in the First-Line Treatment of Extensive-Stage Small Cell Lung Cancer

被引:58
作者
Ding, Dong [1 ]
Hu, Huabin [2 ,3 ]
Li, Shuosha [1 ]
Zhu, Youwen [1 ]
Shi, Yin [4 ]
Liao, Mengting [5 ]
Liu, Jin [6 ]
Tian, Xu [6 ]
Liu, Aiting [7 ]
Huang, Jin [1 ,8 ]
机构
[1] Cent South Univ, Xiangya Hosp, Dept Oncol, Changsha 410008, Hunan, Peoples R China
[2] Sun Yat Sen Univ, Dept Med Oncol, Affiliated Hosp 6, Guangzhou, Peoples R China
[3] Guangdong Inst Gastroenterol, Guangdong Prov Key Lab Colorectal & Pelv Floor Di, Guangzhou, Peoples R China
[4] Cent South Univ, Xiangya Hosp, Dept Pharm, Changsha, Hunan, Peoples R China
[5] Cent South Univ, Xiangya Hosp, Hlth Management Ctr, Changsha, Hunan, Peoples R China
[6] Cent South Univ, Sch Comp Sci & Engn, Changsha, Peoples R China
[7] Hunan Healthcare Secur Adm, Changsha, Peoples R China
[8] Cent South Univ, Hunan Key Lab Skin Canc & Psoriasis, Hunan Engn Res Ctr Skin Hlth & Dis, Dept Dermatol,Xiangya Hosp, Changsha, Hunan, Peoples R China
来源
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK | 2021年 / 19卷 / 10期
基金
湖南省自然科学基金;
关键词
PHASE-III; PEMBROLIZUMAB; IPILIMUMAB; TOPOTECAN; THERAPY; PD-L1; NSCLC; 1ST;
D O I
10.6004/jnccn.2020.7796
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: In the CASPIAN trial, durvalumab + chemotherapy demonstrated significant improvements in overall survival compared with chemotherapy alone in patients with extensive-stage small cell lung cancer (SCLC). We aimed to assess the cost-effectiveness of durvalumab in patients with extensive-stage SCLC from the US healthcare system perspective. Patients and Methods: A comprehensive Markov model was adapted to evaluate cost and effectiveness of durvalumab combination versus platinum/etoposide alone in the first-line therapy of extensive-stage SCLC based on data from the CASPIAN study. The main endpoints included total costs, life years (LYs), quality-adjusted life-years (QALYs), and incremental coste-ectiveness ratios (ICERs). Model robustness was assessed with sensitivity analysis, and additional subgroup analyses were also performed. Results: Durvalumab + chemotherapy therapy resulted in an additional 0.27 LYs and 0.20 QALYs, resulting in an ICER of $464,711.90 per QALY versus the chemotherapy treatment. The cost of durvalumab has the greatest influence on this model. Subgroup analyses showed that the ICER remained higher than $150,000/ QALY (the willingness-to-pay threshold in the United States) across all patient subgroups. Conclusions: Durvalumab in combination with platinum/etoposide is not a cost-effective option in the first-line treatment of patients with extensive-stage SCLC.
引用
收藏
页码:1141 / +
页数:11
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