Journal
EXPERT REVIEW OF PHARMACOECONOMICS & OUTCOMES RESEARCH
Volume 21, Issue 5, Pages 1061-1067Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/14737167.2021.1899813
Keywords
Cost-effectiveness; non-small cell lung cancer; atezolizumab; Markov model; China
Funding
- China Pharmaceutical University (Fundamental Research Funds for the Central Universities) [2632020PY06]
- National Natural Science Foundation of China [72004231]
- Primary Research and Development Project of Jiangsu Province [BE2018670]
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The study assessed the cost-effectiveness of atezolizumab in combination with chemotherapy versus chemotherapy alone for treating advanced non-squamous NSCLC in the Chinese healthcare system. Results showed that atezolizumab combination therapy is not cost-effective in this setting.
Objective: To assess the cost-effectiveness of atezolizumab in combination with carboplatin plus nab-paclitaxel-based chemotherapy versus chemotherapy alone for first-line treatment of advanced non-squamous non-small cell lung cancer (NSCLC) from the Chinese healthcare system perspective. Methods: A Markov model was developed based on the IMpower130 clinical trial. Drug costs and health state utility were obtained from the literature. Outcomes included life-years (LYs), quality-adjusted life-years (QALYs), lifetime costs, and incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were performed to evaluate the model uncertainty. Results: When compared to chemotherapy alone, atezolizumab plus chemotherapy provides an additional 0.34 LY and 0.19 QALY, and has an ICER of $180,560.15 per additional LY gained and that of $325,328.71 per QALY gained. Sensitivity analysis revealed that the results were most sensitive to changes in atezolizumab cost. Probabilistic sensitivity analysis showed that there was a 0% probability that atezolizumab plus chemotherapy was cost-effective at willingness-to-pay values of $30,828 per QALY. If the WTP threshold increased to $325,000 per QALY, atezolizumab plus chemotherapy has a 50% chance to be cost-effective. Conclusions: From the Chinese healthcare system perspective, atezolizumab combination is not cost-effective for first-line therapy of advanced non-squamous NSCLC.
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