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Cost-Effectiveness of Nivolumab Plus Ipilimumab Combined with Two Cycles of Chemotherapy as First-Line Treatment in Advanced Non-Small Cell Lung Cancer

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Abstract

Introduction

The effectiveness of nivolumab plus ipilimumab with two cycles of chemotherapy (NIC) for advanced non-small cell lung cancer (NSCLC) has been demonstrated. We aimed to evaluate the cost-effectiveness of NIC for advanced NSCLC from the US payer perspective.

Methods

A Markov model has been established to predict the disease course of previously untreated advanced NSCLC. The clinical data were derived from the CheckMate 9LA trial. Cost and utility were obtained from the literature. Model outputs included the incremental cost-effectiveness ratios (ICERs), incremental monetary benefit (INMB), and incremental net-health benefit (INHB). A series of sensitivity analyses were performed to analyze the uncertainty of the model.

Results

Our results showed that NIC versus chemotherapy alone cost $264,278 and yielded an additional 0.80 quality-adjusted life-years (QALYs), which led to an ICER of $202,275/QALY gained. The INHB was − 0.28 QALY, and the INMB was − $41,865 at the threshold of $150,000/QALY. The results of one-way sensitivity analysis showed that the hazard ratio of overall survival was the most sensitive parameter.

Conclusion

NIC was unlikely to be cost-effective as a first-line treatment for patients with advanced NSCLC.

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Acknowledgements

Funding

The work was supported by grants from the National Natural Science Foundation of China (grant numbers 82073818 and 71874209); and the Key Science-Technology Research and Development Program of Hunan Province (grant number 2020JJ8046); and the Hunan Provincial Natural Science Foundation of China (grant number 2019JJ40411). The journal’s Rapid Service Fee was funded by the study sponsor.

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’s Contributions

Study design and supervision: XW and CT; data analysis and interpretation: SL, LY, XL; data collection: LP, LW, SQ, QL; manuscript writing: YP and XZ; final approved of manuscript: All authors.

Disclosures

Ye Peng, Xiaohui Zeng, Liubao Peng, Qiao Liu, Lidan Yi, Xia Luo, Sini Li, Liting Wang, Shuxia Qin, Xiaomin Wan and Chongqing Tan declare no conflicts of interest.

Compliance with Ethics Guidelines

This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors.

Data Availability

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

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Author notes

  1. Ye Peng and Xiaohui Zeng contributed equally to this work.

Authors and Affiliations

  1. Department of Pharmacy, The Second Xiangya Hospital of Central South University, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China

    Ye Peng, Liubao Peng, Qiao Liu, Lidan Yi, Xia Luo, Sini Li, Liting Wang, Shuxia Qin, Xiaomin Wan & Chongqing Tan

  2. PET-CT Center, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China

    Xiaohui Zeng

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  1. Ye Peng
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Correspondence to Xiaomin Wan or Chongqing Tan.

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Peng, Y., Zeng, X., Peng, L. et al. Cost-Effectiveness of Nivolumab Plus Ipilimumab Combined with Two Cycles of Chemotherapy as First-Line Treatment in Advanced Non-Small Cell Lung Cancer. Adv Ther 38, 3962–3972 (2021). https://doi.org/10.1007/s12325-021-01788-6

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