![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
Abstract
Background and objective
Sintilimab is a selective PD-1 inhibitor with efficacy in advanced or metastatic nonsquamous non-small-cell lung cancer (NSCLC) patients. This study evaluated the cost-effectiveness of sintilimab + chemotherapy versus camrelizumab + chemotherapy as the first-line treatment for locally advanced or metastatic nonsquamous NSCLC in Chinese patients. In addition, this study aimed to reveal the impact of the reference treatment choice on the incremental cost-effectiveness ratio (ICER) results.
Methods
A partitioned survival model (PSM) with three health states was constructed in a 3-week cycle with a lifetime horizon from the Chinese healthcare system perspective. Anchored matching adjusted indirect comparison was used for survival analyses based on individual patient data from Orient-11. Sintilimab + chemotherapy was chosen as the reference treatments in scenarios 1 and 2, while the camrelizumab + chemotherapy was chosen as the reference treatments in scenario 3. The utility values of different health states were derived from the patient-level European Organization for Research and Treatment Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) scores by mapping to the EQ-5D-5L, and QALYs were calculated as the health outcomes. One-way deterministic sensitivity analysis (DSA) and probability sensitivity analysis (PSA) were performed to explore model uncertainty.
Results
Compared to camrelizumab + chemotherapy, sintilimab + chemotherapy was associated with higher effectiveness (incremental QALYs ranged from 0.13–0.62) and lower total costs (incremental costs ranged from $1,099–$5,201), resulting in an ICER ranging from $6,440–$8,454/QALY.
Conclusions
Sintilimab + chemotherapy is a cost-effective option compared with camrelizumab + chemotherapy as the first-line treatment for locally advanced or metastatic nonsquamous NSCLC in China.
Transparency
Declaration of funding
Support for this study was provided by Innovent Biologics (Suzhou) Co., Ltd., Suzhou, Jiangsu, China. The authors were responsible for all content and editorial decisions, and they received no honoraria related to the development of this publication.
Declaration of financial/other relationships
MR, ZF, YW, XZ, AM, and HL have no conflicts of interest that are directly relevant to the content of this article. HS is an employee of Innovent Biologics (Suzhou). HS did not receive direct payment as a result of this work outside of his normal salary payments.
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Author contributions
MR: Study design, data collection, data analysis, interpretation of results, writing of draft and final manuscript. ZF: Data collection, data analysis, interpretation of results, writing of draft and final manuscript. YW: Study design, data analysis, writing of draft and final manuscript. XZ: data collection, writing of draft and final manuscript. AM: Interpretation of results, final manuscript. HS: Study design, data analysis, interpretation of results, final manuscript. HL: Study design, interpretation of results, writing of draft and final manuscript. All authors contributed to the drafting and revision of the manuscript, and approved it for submission. HL is the principal investigator and will act as total guarantor for the study.
Acknowledgements
The authors thank American Journal Experts for providing English language, grammar, punctuation, spelling, and overall style editing.
Data availability statement
The authors declare that all input data to parameterize the decision analytic model are available within the article and the Supplementary Material.
Ethics approval
Not applicable.
