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

ABSTRACT

Objectives

Durvalumab plus chemotherapy could significantly improve overall survival compared with chemotherapy alone in the first-line treatment of extensive-stage small-cell lung cancer (SCLC). However, its long-term economic outcomes remain unclear yet. This study aimed to evaluate the cost-effectiveness of adding durvalumab to first-line chemotherapy for extensive-stage SCLC from the perspective of the Chinese health-care system.

Methods

A decision-analytic model with 10-year horizon was developed to estimate the health and economic outcomes of adding durvalumab to first-line treatment for extensive-stage SCLC. The primary outcomes included total costs, life years (LYs), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). Costs and utility values were obtained from the published literature. A scenario analysis for a patient assistance program (PAP) was conducted. Sensitivity analyses were performed to explore the robustness of the model outcomes.

Results

Durvalumab plus chemotherapy yielded additional 0.25 QALYs, with incremental costs of 76,354 USD, resulting in an ICER of 302,051 USD/QALY compared with chemotherapy alone, when PAP was available, the ICER was 192,591 USD/QALY. Sensitivity analyses confirmed the robustness of model outcomes.

Conclusion

Adding durvalumab to first-line chemotherapy for extensive-stage small-cell lung cancer is unlikely to be cost-effectiveness in China.

KEYWORDS:

• Durvalumab
• chemotherapy
• first-line treatment
• extensive-stage small-cell lung cancer
• cost-effectiveness analysis
• 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.

Reviewers disclosure

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

Authors contribution statement

GQL and SK were involved in the design of the study, GQL and SK were collected the data and performed the economic analysis. GQL and SK drafted and critically revised the manuscript. All the authors have agreed to its content and submission for publication.

Supplementary material

Supplemental data for this article can be accessed here.