Kexun Zhou1, Jing Zhou1, Jiaxing Huang1, Nan Zhang1, Liangliang Bai1, Yu Yang1, Qiu Li2. 1. Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37, GuoXue Xiang Chengdu, Sichuan, 610041, China; West China Biomedical Big Data Center, Sichuan University, No. 37, GuoXue Xiang Chengdu, Sichuan, 610041, China. 2. Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37, GuoXue Xiang Chengdu, Sichuan, 610041, China; West China Biomedical Big Data Center, Sichuan University, No. 37, GuoXue Xiang Chengdu, Sichuan, 610041, China. Electronic address: fbqiu9@163.com.
Abstract
OBJECTIVES: A double-blind, placebo-controlled, phase 3 trial has shown atezolizumab plus chemotherapy in the first-line treatment of extensive-stage small-cell lung cancer could significantly prolong overall survival and progression-free survival than chemotherapy alone. This study aimed to assess the cost-effectiveness of atezolizumab plus chemotherapy as first-line treatment for patients with extensive-stage small-cell lung from an American perspective. MATERIALS AND METHODS: Basic medical information was derived from the double-blind, placebo-controlled, phase 3 trial (IMpower133, NCT02763579). A Markov model was developed to simulate the process of small-cell lung cancer, including three health states: progression-free survival (PFS), progressive disease (PD), and death. Utilities and costs were obtained from published resources. Sensitivity analyses were applied to explore the impact of essential variables. RESULTS: Treatment with atezolizumab plus chemotherapy was estimated to increase costs by $52,881compared with chemotherapy alone, with a gain of 0.10 quality adjusted life years (QALYs), leading to an incremental cost-effective ratio of $528,810 per QALY. The cost of PFS state and atezolizumab were the most influential factors to the model. CONCLUSION: The combination of atezolizumab, carboplatin and etoposide is not a cost-effective choice in the first-line treatment of extensive-stage SCLC from an American perspective.
RCT Entities:
OBJECTIVES: A double-blind, placebo-controlled, phase 3 trial has shown atezolizumab plus chemotherapy in the first-line treatment of extensive-stage small-cell lung cancer could significantly prolong overall survival and progression-free survival than chemotherapy alone. This study aimed to assess the cost-effectiveness of atezolizumab plus chemotherapy as first-line treatment for patients with extensive-stage small-cell lung from an American perspective. MATERIALS AND METHODS: Basic medical information was derived from the double-blind, placebo-controlled, phase 3 trial (IMpower133, NCT02763579). A Markov model was developed to simulate the process of small-cell lung cancer, including three health states: progression-free survival (PFS), progressive disease (PD), and death. Utilities and costs were obtained from published resources. Sensitivity analyses were applied to explore the impact of essential variables. RESULTS: Treatment with atezolizumab plus chemotherapy was estimated to increase costs by $52,881compared with chemotherapy alone, with a gain of 0.10 quality adjusted life years (QALYs), leading to an incremental cost-effective ratio of $528,810 per QALY. The cost of PFS state and atezolizumab were the most influential factors to the model. CONCLUSION: The combination of atezolizumab, carboplatin and etoposide is not a cost-effective choice in the first-line treatment of extensive-stage SCLC from an American perspective.
Authors: Ramon Andrade De Mello; Jin-Hui Zhu; Jairo Iavelberg; Artur Henrique Potim; Débora Simonetti; José Antônio Silva; Pedro Castelo-Branco; Daniel Humberto Pozza; Carla Chizuru Tajima; Maria Tolia; Georgio Antoniou Journal: Transl Lung Cancer Res Date: 2020-12
Authors: Guiyuan Xiang; Lingna Gu; Xuan Chen; Fan Wang; Bohua Chen; Jie Zhao; Yun Lu; Feng Chang; Yumei Zhu Journal: Front Public Health Date: 2021-12-10