Economic evaluation of toripalimab plus chemotherapy compared with chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma in China

ABSTRACT

Objectives

The purpose of this study was to compare the cost-effectiveness of toripalimab versus Chemotherapy for patients with advanced esophageal squamous cell carcinoma (ESCC) from the perspective of the Chinese healthcare system.

Methods

A partitioned survival model was designed. Clinical data on survival was taken from the JUPITER-06 trials. Direct medical expenditures and utilities were gathered from published literature and a local database. One-way and probability sensitivity methods were used to evaluate the model’s robustness.

Results

Compared with chemotherapy alone, toripalimab offered an incremental cost of $8950.427 with an additional 0.294 QALYs, yielding an ICER of 30,443.629$/QALYs first-line therapy for advanced ESCC. The ICER was below the threshold of willingness to pay in China, indicating that the toripalimab group had a cost-effective advantage. Sensitivity analysis showed that the ICERs were most sensitive to the utility of PD, but all the parameters had no significant impact on the model’s outcomes.

Conclusion

Toripalimab may be a cost-effective first-line treatment choice in our research when compared to chemotherapy alone for patients with advanced ESCC.

KEYWORDS:

• Esophageal squamous cell carcinoma
• Recurrent or metastatic
• Cost-effectiveness
• Toripalimab
• Chemotherapy

Article highlights

• This is a study to evaluate the cost-effectiveness of toripalimab combination therapy in the treatment of advanced ESCC patients from the perspective of the Chinese healthcare system.

• The ICER of toripalimab plus chemotherapy for first-line treatment of advanced ESCC in China was $30443.629/QALY.

• Toripalimab maybe a cost-effective first-line treatment choice for patients with advanced ESCC.

Declaration of interest

The authors have no other 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 apart from those disclosed.

Reviewer disclosures

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

Authors’ contributions

The study was conducted Z Zheng by and H Zhu. Z Zheng wrote and edited the article. Project management and statistical analysis support came from H Cai. Software analysis was carried out by L Fang. All authors approved the final version to be published.

Ethics approval and consent to participate

Our study did not require permission from a hospital research ethics committee because our cost-effectiveness analysis was based on previous research and computer modeling methods.

Availability of data and material

Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2206570.

Additional information

Funding

This paper as funded by Shantou Science and Technology Project (Grant No(2022)81-132).