Cost-effectiveness of adding serplulimab to first-line chemotherapy for extensive-stage small-cell lung cancer in China

ABSTRACT

Objective

The aim of the current study was to evaluate the cost-effectiveness of serplulimab plus chemotherapy compared chemotherapy alone as first-line strategy for patients with ES-SCLC in China.

Methods

A decision-analytic model that based on the Chinese health-care system perspective was conducted to evaluate the economic benefits for the two competing first-line treatment. The clinical survival and safety data were obtained from the ASTRUM-005 trial, cost and utility values were gathered from the local charges and previously published study. Both cost and utility values were discounted at an annual rate of 5%. Sensitivity analyses and subgroup analyses were performed to examine the robustness of the model results.

Results

Serplulimab plus chemotherapy could bring additional 0.25 QALYs with the marginal cost of $37,569.32, resulting in an ICER of $147,908.74 per additional QALY gained. Sensitivity analyses confirmed that model results were robust. Subgroup analyses revealed that adding serplulimab to first-line chemotherapy were unlikely to be the cost-effective option for all subgroup patients.

Conclusions

Serplulimab plus chemotherapy was unlikely to be the cost-effective first-line strategy compared with chemotherapy alone for patients with ES-SCLC in China. Reduced the price of serplulimab could increase its cost-effective.

KEYWORDS:

• Serplulimab
• chemotherapy
• extensive-stage small-cell lung cancer
• cost-effectiveness
• first-line therapy
• pharmacoeconomics

Article highlights

• The ASTRUM-005 trial motivated great interest for both oncologists and health-care decision makers after the reports of the effectiveness and safety profile from serplulimab plus chemotherapy for ES-SCLC. This current study aimed to investigate the cost-effectiveness of adding serplulimab to first-line chemotherapy for patients with ES-SCLC in China.

• Serplulimab plus chemotherapy yield marginal cost of $ 37569.32 and an additional 0.25 QALYs, resulting in an ICER of $147,908.74/QALY, which higher than willingness-to-pay (WTP) threshold of $37,652/QALY in China. When the price of serplulimab reduced 90%, serplulimab plus chemotherapy could be considered the cost-effective first-line option.

• Adding serplulimab to first-line chemotherapy could not be considered cost-effective for patients with ES-SCLC in China, it is necessary to reduce the price of serplulimab to improve its cost-effective.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Author contributions

SK and HLL were involved in the design of the study, SK were collected the data and performed the economic analysis. SK and HLL drafted and critically revised the manuscript. All authors contributed to the article and approved the submitted version.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2281606

Additional information

Funding

This paper was not funded.