Economic value of toripalimab plus axitinib as first-line treatment for advanced renal cell carcinoma in China: a model-based cost-effectiveness analysis

ABSTRACT

Objective

The current analysis aimed to evaluate the economic benefit of toripalimab plus axitinib for previously untreated RCC patients from the Chinese healthcare system perspective.

Methods

The partitioned survival model was developed to simulate 3-week patients’ transition in 20-year time horizon to evaluate the cost-effectiveness of toripalimab plus axitinib compared with sunitinib for advanced RCC. Survival data were gathered from the RENOTORCH trial, and cost and utility inputs were obtained from the database and published literature. Total cost, life-years (LYs), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) were the model outputs. Subgroup analyses and sensitivity analyses were conducted to increase the comprehensiveness and estimate the robustness of the model results.

Results

In the base-case analysis, compared with sunitinib, toripalimab plus axitinib could bring additional 1.19 LYs and 0.65 QALYs, with the marginal cost of $41,499.23, resulting in the ICER of $64,337.49/QALY, which is higher than the WTP threshold. And ICERs were always beyond the WTP threshold of all subgroups. Sensitivity analyses demonstrated the model results were robust.

Conclusions

Toripalimab plus axitinib was unlikely to be the cost-effective first-line therapy for patients with previously untreated advanced RCC compared with sunitinib from the Chinese healthcare system perspective.

KEYWORDS:

• Toripalimab
• axitinib
• sunitinib
• advanced renal cell carcinoma
• cost-effectiveness analysis
• partitioned survival model

Article highlights

• The RENOTORCH trial motivated great interest for healthcare decision makers after the reports of the clinical benefit and safety profile from toripalimab plus axitinib for patients with advanced RCC.

• The current study aimed to access the cost-effectiveness of toripalimab plus axitinib versus sunitinib as first-line treatment for patients with previously untreated advanced RCC from Chinese healthcare system perspective.

• Toripalimab plus axitinib yields additional 0.65 QALYs with marginal cost of $41,499.23, resulting in an ICER of $64,337.49/QALY, which is higher than willingness-to-pay (WTP) threshold of $38,223/QALY in China. Subgroup and sensitivity analyses confirmed the robustness of the model results.

• Toripalimab plus axitinib was unlikely to be the cost-effective first-line option for patients with advanced RCC due to the unfavorable ICERs.

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.

Author contributions

S Kang and J T Yin were involved in the design of the study. S Kang collected the data and performed the economic analysis. S Kang and J T Yin drafted and critically revised the manuscript. All authors contributed to the article and approved the submitted version.

Reviewer disclosures

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

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2024.2333334

Additional information

Funding

This paper was not funded.