Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/285302 
Year of Publication: 
2022
Citation: 
[Journal:] Health Economics Review [ISSN:] 2191-1991 [Volume:] 12 [Issue:] 1 [Article No.:] 66 [Year:] 2022 [Pages:] 1-10
Publisher: 
Springer, Heidelberg
Abstract: 
Objective: In frst-line treatment of advanced or metastatic nonsquamous non-small-cell lung cancer (NSCLC), the ORIENT-11 study demonstrated a signifcant progression-free survival and overall survival for sintilimab plus chemotherapy in comparison with chemotherapy alone. But the cost-effectiveness of the two treatment schemes is unclear in China. The objective of the current study was to evaluate the cost efectiveness of sintilimab plus chemotherapy versus Platinum-based chemotherapy for locally advanced or metastatic squamous NSCLC in China. Methods: We performed an economic evaluation from the perspective of the Chinese healthcare system using a partitioned survival model with three mutually exclusive health states: progression free, post-progression, and death. The circulation cycle of the model was 3 weeks and the study time limit was 10 years. Efficacy data were obtained from the ORIENT-11 clinical trial. Cost and utility values were derived from published studies and online price databases. The primary outcomes of the model were quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs). One-way sensitivity analysis and probability sensitivity analysis were used to verify the robustness of the base-case analysis results. Results: Sintilimab plus chemotherapy provided an additional 0.6 QALYs. The total cost per patient was CNY¥413,273.16 for sintilimab plus chemotherapy and CNY¥280,695.23 for Platinum-based chemotherapy. The ICER for sintilimab plus chemotherapy was CNY¥220,963.22/QALY. Sensitivity analyses found the results to be most sensitive to the cost of pemetrexed and utilities of PF state. In the probabilistic sensitivity analysis, sintilimab was cost-efective in 78.6% of the simulations, assuming a willingness-to-pay threshold (WTP) of CNY¥242,928 per QALY. Conclusion: Compared with chemotherapy alone, the sintilimab plus chemotherapy is likely to be a cost-effective option as the first-line treatment for locally advanced or metastatic nonsquamous NSCLC in China.
Subjects: 
Non-small cell lung cancer
Sintilimab
Cost-efectiveness analysis
Partitioned survival model
Persistent Identifier of the first edition: 
Creative Commons License: 
cc-by Logo
Document Type: 
Article

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