Cost-effectiveness analysis of toripalimab plus chemotherapy for patients with advanced esophageal squamous cell carcinoma in China

ABSTRACT

Background

The aim of the current analysis was to evaluate the cost-effectiveness of toripalimab plus chemotherapy compared with chemotherapy alone as the first-line option for patients with advanced esophageal squamous cell carcinoma (ESCC) from the perspective of Chinese health-care system.

Methods

A partitioned survival model was conducted to track 3-week patients’ transition and evaluate the health and economic outcomes in 10-year horizon of the two competing first-line treatment among toripalimab plus chemotherapy and chemotherapy alone. The survival data were gathered from the JUPITER-06 trial, and cost and utility values were obtained from the local charges and published studies. Total costs, life-years, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) were the model outcomes. Sensitivity and subgroup analyses were conducted.

Results

Treatment with toripalimab plus chemotherapy yields marginal cost of $8,639.74 and additional 0.65 QALYs, resulting in an ICER of $13,280.97 per additional QALY gained, which was lower than the willingness-to-pay (WTP) threshold of $38,224 in China. Sensitivity and subgroup analyses confirmed the robustness of the model outcomes.

Conclusions

Toripalimab plus chemotherapy was likely to be the cost-effective first-line option for patients with advanced ESCC compared with chemotherapy alone with the WTP threshold of $38,224 per additional QALY gained from the perspective of the Chinese health-care system.

KEYWORDS:

• Toripalimab
• chemotherapy
• esophageal squamous cell carcinoma
• cost-effectiveness
• pharmacoeconomic

Article highlights

• The unmet clinical benefit provided a chance of new drugs to enhance the survival rate of first-line chemotherapy for patients with advanced ESCC. The JUPITER-06 trial motivated great interest for both health-care decision-makers and oncologists after the reports of the effectiveness and safety profile from toripalimab plus chemotherapy for advanced ESCC.

• The aim of the current analysis was to investigate the cost-effectiveness of adding toripalimab to first-line chemotherapy for patients with advanced ESCC from the perspective of Chinese health-care system.

• Toripalimab plus chemotherapy yields additional 0.65 QALYs with the marginal cost of $8,639.74, resulting in an ICER of $13,280.97/QALY, which was lower than WTP threshold of $38,224/QALY in China. Sensitivity and subgroup analyses demonstrated the robustness of the model results.

• Adding toripalimab to first-line chemotherapy was likely to be cost-effective for patients with advanced ESCC in China.

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.

Reviewer disclosures

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

Author contributions

S Kang, ZH Pan, and HL Liu were involved in the design of the study. S Kang and XH Wang collected the data and performed the economic analysis. S Kang and HL Liu 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/10.1080/14737167.2023.2270159.

Additional information

Funding

This paper was not funded.