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The Cost-Effectiveness of Sugemalimab Plus Chemotherapy as First-Line Treatment for Metastatic Squamous and Non-squamous NSCLC in China

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Abstract

Introduction

Sugemalimab is the first China-developed programmed death-ligand 1 inhibitor that has proved to be effective as a first-line treatment for both metastatic squamous and non-squamous non-small cell lung cancer (NSCLC) when used in combination with chemotherapy. This study compared the cost-effectiveness of sugemalimab plus chemotherapy (sugema + chemo) with placebo plus chemotherapy (placebo + chemo) among metastatic squamous and nonsquamous NSCLC, respectively.

Methods

Separate Markov models were constructed to generate the cumulative healthcare costs and quality-adjusted life-years (QALYs) associated with two treatment strategies over a 20-year time horizon. Transition probabilities were estimated using survival data reported in the GEMSTONE-302 trial. Health state utilities and costs were derived from published literature, national databases, and local general hospitals. Sensitivity analyses were performed to test the robustness of our conclusions.

Results

Compared with first-line placebo + chem, sugema + chemo achieved an incremental cost-effectiveness ratio (ICER) of $57,842/QALY for patients with metastatic squamous NSCLC and achieved an ICER of $78,249/QALY for patients with metastatic non-squamous NSCLC. In our sensitivity analyses of a willingness-to-pay (WTP) threshold of $35,663 per QALY, the first-line sugema + chemo was only cost-effective for patient groups when the price of sugemalimab decreased.

Conclusion

Sugema + chemo was not cost-effective as a first-line treatment for either metastatic squamous or metastatic nonsquamous NSCLC in Chinese patients compared with placebo + chemo. However, we found that sugema + chemo would be cost-effective in patients with metastatic squamous and non-squamous NSCLC when sugemalimab’s price was decreased by > 39.0% and 64.8%, respectively.

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Acknowledgements

Funding

No funding or sponsorship was received for this study or publication of this article. The Rapid Service Fee was funded by the authors.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Author Contributions

Rihua Cheng and Qiao Liu developed the economic model, performed the analyses, interpreted the results and drafted the article. Rihua Cheng and Zhen Zhou collected and reviewed the data. Qiao Liu contributed to the conception and design of the primary model. All authors read and approved the final article.

Disclosures

Rihua Cheng, Zhen Zhou and Qiao Liu declare they have nothing to disclose.

Compliance with Ethics Guidelines

The model used in this analysis was based on previously conducted studies and other economic models; no studies with human participants or animals were performed by any of the authors. Since no individual patient-level data were involved, this study was exempted from the review by the Chinese ethics review committee.

Data Availability Statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Pharmacy, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, Hunan, China

    Rihua Cheng

  2. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    Zhen Zhou

  3. Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410000, Hunan, China

    Qiao Liu

Authors
  1. Rihua Cheng
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  2. Zhen Zhou
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Corresponding author

Correspondence to Qiao Liu.

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Cheng, R., Zhou, Z. & Liu, Q. The Cost-Effectiveness of Sugemalimab Plus Chemotherapy as First-Line Treatment for Metastatic Squamous and Non-squamous NSCLC in China. Adv Ther 40, 4298–4309 (2023). https://doi.org/10.1007/s12325-023-02594-y

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