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Cost-Effectiveness Analysis of Toripalimab Plus Paclitaxel and Cisplatin as First-Line Treatment for Advanced or Metastatic Esophageal Squamous Cell Carcinoma

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Abstract

Introduction

First-line treatment with toripalimab plus paclitaxel and cisplatin (TTP) is very effective for patients with advanced or metastatic esophageal squamous cell carcinoma (ESCC) in China, although its effects on economic burden are unknown. The present study aimed to evaluate the cost-effectiveness of TTP from the perspective of the Chinese healthcare system.

Methods

A Markov model was established to evaluate the cost-effectiveness of first-line treatment with TTP for patients with advanced or metastatic ESCC. Survival data were derived from the JUPITER-06 trial. The costs and utilities were gathered from the literature and a local database. The primary outcomes were total costs, quality-adjusted life year (QALY), and incremental cost-effectiveness ratios (ICERs) at a willingness-to-pay (WTP). One-way and probability sensitivity analyses were used to evaluate the robustness of the model.

Results

The total cost of TTP was $123,646.43 and gained 1.10 QALYs, while the paclitaxel and cisplatin (TP) chemotherapy group yielded 0.84 QALY at cost of $16,259.65. First-line TTP treatment yielded an incremental cost of $7,386.78 with an additional 0.26 QALY, providing an ICER of $28,348.42/QALY, which was lower than the WTP threshold ($36,257.91) in China.

Conclusions

TTP was likely more cost-effective than TP chemotherapy from the perspective of the Chinese healthcare system. This study may provide evidence required to establish decision-making criteria to support guidance for cost-effective selection of an immunotherapeutic regimen.

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Acknowledgements

Funding

This work and publication was supported by the Hospital Pharmaceutical Research Foundation of Guangdong Province (No.2022A35) and Pharmaceutical Scientific Research Foundation of Guangdong Provincial Hospital Association (No.2021YXQN10).

Author Contributions

Rui Fang: Study concepts and design, manuscript preparation, manuscript editing, literature research, experimental studies/data analysis. Suiqiong Wang: Manuscript editing, literature research. Yongqian Liu: Manuscript editing. Jun Xu: Guarantor of integrity of the entire study, manuscript editing.

Disclosures

Rui Fang, Suiqiong Wang, Yongqian Liu, and Jun Xu declare that they have no competing interests.

Compliance with Ethics Guidelines

This economic analysis was based on a literature review and modeling techniques, and this study did not require approval from an Institutional Research Ethics Board.

Data Availability

All data generated or analyzed during this study are included in this published article/as supplementary information files.

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Authors and Affiliations

  1. Department of Pharmacy, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China

    Rui Fang, Suiqiong Wang & Yongqian Liu

  2. College of Pharmacy, Jinan University, No. 855, Xingye Avenue East, Guangzhou, 511436, Guangdong, China

    Jun Xu

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Fang, R., Wang, S., Liu, Y. et al. Cost-Effectiveness Analysis of Toripalimab Plus Paclitaxel and Cisplatin as First-Line Treatment for Advanced or Metastatic Esophageal Squamous Cell Carcinoma. Adv Ther 40, 1019–1030 (2023). https://doi.org/10.1007/s12325-022-02402-z

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