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ABSTRACT
Objective
The primary objective of this current study is to evaluate the cost-effectiveness of incorporating tislelizumab into the first-line treatment of metastatic or advanced esophageal squamous cell carcinoma (ESCC) in comparison to placebo with chemotherapy.
Method
We conducted a partitioned survival model with a time horizon of 10 years from a Chinese perspective. The direct medical costs were collected from the local setting in China. To enhance the credibility and robustness of the findings, sensitivity analyses were also conducted.
Results
The inclusion of tislelizumab in conjunction with chemotherapy was shown to significantly enhance quality-adjusted life years (QALY) by 0.328 when compared to chemotherapy alone. This improvement comes at an additional cost of $9833.694. The incorporation of tislelizumab into the treatment regimen for advanced ESCC results in an incremental cost-effectiveness ratio (ICER) of $29980.774/QALY gained, which falls below the WTP threshold of $37304.346/QALY in China. One-way sensitivity analyses showed that no parameters were found to be adjustable within a specific range without altering the overall outcomes of our study.
Conclusion
Tislelizumab plus chemotherapy as first-line treatment for advanced or metastatic ESCC is may be a cost-effective option compared to chemotherapy alone.
Abbreviations
| ESCC | = | esophageal squamous cell carcinoma |
| QALY | = | quality adjusted life years |
| ICER | = | incremental cost effectiveness ratio |
| PD | = | progressive disease |
| PFS | = | progression free survival |
| WTP | = | willingness to pay |
| GDP | = | gross domestic product |
| AIC | = | akaike information criterion |
| BIC | = | bayesian information criterion |
| AEs | = | adverse events |
| ICIs | = | immune checkpoint inhibitors |
| TEAEs | = | treatment-emergent adverse events |
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
Z Zheng made significant contributions to the conception and design of the research. H Zhu and H Cai performed data collection and conducted statistical analysis. Z Zheng drafted the initial version of the article, which was subsequently revised and refined. H Chen reviewed and provided final approval for the manuscript. All authors thoroughly reviewed and approved the final version of the manuscript.
Ethics approval and consent to participate
Our cost-effectiveness study utilized computer modeling techniques and extensively referenced pertinent literature in the field. Given that our research did not involve the inclusion of human subjects or data, it was deemed exempt from review by a hospital research ethics board.Availability of data and material
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Availability of data and material
The data used in the current investigation are available at a reasonable request from the corresponding author.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Supplementary Material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2290609