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ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 |
doi: 10.3389/fimmu.2024.1477146
This article is part of the Research Topic Immune Plasticity and Cancer: Augmenting Therapeutic Potential of Immunotherapy against Tumor Diseases View all articles
Cost-effectiveness analysis of benmelstobart, anlotinib, and chemotherapy in extensive-stage small-cell lung cancer
Provisionally accepted- Mindong Hospital, Fujian Medical University, Ningde, China
Abstract Background: The ETER701 trial assessed the efficacy and safety of benmelstobart combined with anlotinib plus etoposide/cisplatin (BEN-AL-EC) as a first-line therapy for extensive-stage small-cell lung cancer (ES-SCLC). Results indicated that BEN-AL-EC, when compared with placebo in combination with etoposide/cisplatin (PLB-EC), significantly enhanced both progression-free and overall survival rates, while demonstrating an acceptable safety profile among patients with ES-SCLC. However, BEN-AL-EC is expensive, necessitating its cost-effectiveness analysis. Methods: A Markov model with three health states was developed to evaluate the cost-effectiveness of BEN-AL-EC, AL-EC and PLB-EC for the treatment of ES-SCLC from the perspective of the Chinese healthcare system. Drug costs were derived from national tender prices, whereas other costs and utility values were derived from published literature. The key outcomes assessed included total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). Sensitivity analyses, including one-way and probabilistic analyses, were performed to assess the robustness of the model. Results: The total cost of BEN-AL-EC was $55,117.42, yielding 1.09 QALYs, whereas that of PLB-EC was $15,238.15, yielding 0.71 QALYs. The ICER of BEN-AL-EC compared with PLB-EC was $106,249.42 per QALY gained. At a willingness-to-pay threshold of $38,133 per QALY, BEN-AL-EC had a 0% probability of being cost-effective relative to PLB-EC. The key parameters influencing these outcomes included utility values for PFS, the cost of benmelstobart, and the discount rate. Conclusion: From the perspective of the Chinese healthcare system, BEN-AL-EC as a first-line treatment for ES-SCLC is unlikely to be cost-effective when compared with PLB-EC.
Keywords: Cost-Effectiveness, benmelstobart, Anlotinib, chemotherapy, First-line treatment, extensive-stage small-cell lung cancer
Received: 07 Aug 2024; Accepted: 01 Nov 2024.
Copyright: © 2024 You, Luo, Chen and He. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lingling Luo, Mindong Hospital, Fujian Medical University, Ningde, China
Shaofang Chen, Mindong Hospital, Fujian Medical University, Ningde, China
Ying He, Mindong Hospital, Fujian Medical University, Ningde, China
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