Cost-effectiveness analysis of first-line serplulimab plus chemotherapy for advanced squamous non-small-cell lung cancer in China: based on the ASTRUM-004 trial

ABSTRACT

Objective

In the ASTRUM-004 trial, serplulimab plus chemotherapy demonstrated significantly improved survival and controllable safety. This study assessed the cost-effectiveness of serplulimab plus chemotherapy in advanced squamous non‐small cell lung cancer (sqNSCLC), considering the perspective of the Chinese healthcare system.

Methods

A decision tree and a Markov model were constructed to simulate the treatment. The interesting results included total cost, life-years (LYs), quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs). Scenario, one-way and probabilistic sensitivity analyses were used to examine model instability.

Results

Compared with placebo plus chemotherapy, serplulimab plus chemotherapy had an ICER of $55,539.46/QALY ($47,278.84/LY). The ICERs were estimated to be $58,706.03/QALY, $48,978.34/QALY and $59,709.54/QALY inpatients with programmed death-ligand 1 expression level of tumor proportion score (TPS) < 1%, 1% ≤ TPS < 50%, and TPS ≥ 50%. The cost-effective prices of serplulimab were $168.276/100 mg, $349.157/100 mg, and $530.039/100 mg at the willingness-to-pay threshold of $12,574.30/QALY, $25,148.60/QALY, and $37,722.90/QALY. Patient weight and price of serplulimab created the most significant impact. Presently, the probability of serplulimab plus chemotherapy being cost-effective was 14.15%.

Conclusion

Compared with placebo plus chemotherapy, serplulimab plus chemotherapy might not be cost-effective in the first-line treatment for advanced sqNSCLC.

KEYWORDS:

• Cost-effectiveness
• serplulimab
• squamous non-small cell lung cancer
• sqNSCLC
• first-line treatment

Declaration of interest

The author has 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

H Xiang: Conceptualization, Formal analysis, Investigation, Methodology, Writing – original draft. K Meng: Conceptualization, Formal analysis, Methodology, Writing – original draft. M Wu: Conceptualization, Formal analysis, Investigation, Writing – original draft. C Tan: Conceptualization, Formal analysis, Funding acquisition, Investigation, Methodology, Writing – original draft.

Acknowledgments

We express our appreciation to Chongqing Tan for providing us with the analysis tools and funding. We express our appreciation to Andong Li for his help in the methodology and investigation of this research. We sincerely thank Xiaomin Wan and Ouyang Xie for their contributions and help with the methodology and validation of this research.

Availability of data and material

The data that support the findings of this study are available from the corresponding author, Chongqing Tan, upon reasonable request.

Reviewer disclosure

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/10.1080/14737167.2024.2379600

Additional information

Funding

The work was funded by the National Natural Science Foundation of China [grant number: 82073818].