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评估西妥昔单抗在治疗晚期皮肤鳞状细胞癌成人患者中的价值:成本效益分析。

Assessing the Value of Cemiplimab for Adults With Advanced Cutaneous Squamous Cell Carcinoma: A Cost-Effectiveness Analysis.

机构信息

Sanofi, Reading, UK.

Precision HEOR, BC, Canada.

出版信息

Value Health. 2021 Mar;24(3):377-387. doi: 10.1016/j.jval.2020.09.014. Epub 2021 Jan 22.


DOI:10.1016/j.jval.2020.09.014
PMID:33641772
Abstract

OBJECTIVES: To evaluate the cost-effectiveness of cemiplimab in patients with advanced cutaneous squamous cell carcinoma (CSCC) from a payer perspective in the United States. METHODS: A partitioned survival model was developed to assess the cost-effectiveness of cemiplimab versus historical standard of care (SOC). All inputs were identified based on a systematic literature review, supplemented by expert opinion where necessary. Clinical inputs for cemiplimab were based on individual patient data from a cemiplimab phase 2 single-arm trial (NCT27060498). For SOC, analysis was based on a pooled analysis of single-arm clinical trials and retrospective studies evaluating chemotherapy and epidermal growth factor receptor inhibitors (cetuximab, erlotinib, and gefitinib) identified via a systematic literature review (6 of the 27 included studies). Overall survival and progression-free survival were extrapolated over a lifetime horizon. Costs were included for drug acquisition, drug administration, management of adverse events, subsequent therapy, disease management, and terminal care. Unit costs were based on published 2019 US list prices. RESULTS: In the base case, cemiplimab versus SOC resulted in an incremental cost-effectiveness ratio of $99 447 per quality adjusted-life year (QALY), where incremental costs and QALYs were $372 108 and 3.74, respectively. At a willingness-to-pay threshold of $150 000/QALY, the probabilistic sensitivity analysis suggests a 90% probability that cemiplimab is cost-effective compared to SOC. Scenario analyses resulted in incremental cost-effectiveness ratios ranging from $90 590 to $148 738. CONCLUSIONS: Compared with historical SOC, cemiplimab is a cost-effective use of US payer resources for the treatment of advanced CSCC and is expected to provide value for money.

摘要

目的:从支付者角度评估西妥昔单抗在治疗美国晚期皮肤鳞状细胞癌(CSCC)患者中的成本效果。

方法:采用分区生存模型评估西妥昔单抗与历史标准治疗(SOC)相比的成本效果。所有输入均基于系统文献综述确定,并在必要时补充专家意见。西妥昔单抗的临床输入基于西妥昔单抗 2 期单臂试验(NCT027060498)的个体患者数据。对于 SOC,分析基于系统文献综述中确定的单臂临床试验和评估化疗和表皮生长因子受体抑制剂(西妥昔单抗、厄洛替尼和吉非替尼)的回顾性研究的汇总分析。总生存期和无进展生存期在终身范围内进行外推。包括药物获取、药物管理、不良事件管理、后续治疗、疾病管理和终末护理的成本。单位成本基于 2019 年公布的美国目录价格。

结果:在基线情况下,与 SOC 相比,西妥昔单抗的增量成本效果比为每质量调整生命年(QALY)99447 美元,增量成本和 QALY 分别为 372108 美元和 3.74。在 150000 美元/QALY 的支付意愿阈值下,概率敏感性分析表明,与 SOC 相比,西妥昔单抗具有 90%的成本效果可能性。情景分析导致增量成本效果比范围为 90590 美元至 148738 美元。

结论:与历史 SOC 相比,西妥昔单抗是美国支付者资源治疗晚期 CSCC 的一种具有成本效果的方法,预计将物有所值。

相似文献

[1]
Assessing the Value of Cemiplimab for Adults With Advanced Cutaneous Squamous Cell Carcinoma: A Cost-Effectiveness Analysis.

Value Health. 2021-3

[2]
Cost-effectiveness analysis of cemiplimab vs pembrolizumab for treatment of advanced cutaneous squamous cell carcinoma.

J Manag Care Spec Pharm. 2021-11

[3]
Cost-Effectiveness of Cemiplimab Versus Standard of Care in the United States for First-Line Treatment of Advanced Non-small Cell Lung Cancer With Programmed Death-Ligand 1 Expression ≥50.

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[4]
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J Med Econ. 2020-9

[5]
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[6]
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Eur Urol Oncol. 2020-10

[7]
Cost-effectiveness analysis of pembrolizumab versus standard-of-care chemotherapy for first-line treatment of PD-L1 positive (>50%) metastatic squamous and non-squamous non-small cell lung cancer in France.

Lung Cancer. 2018-11-23

[8]
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Pharmacoeconomics. 2017-8

[9]
Cemiplimab in locally advanced cutaneous squamous cell carcinoma: results from an open-label, phase 2, single-arm trial.

Lancet Oncol. 2020-1-14

[10]
Economic evaluation of cemiplimab plus chemotherapy regimen for advanced non-small-cell lung cancer.

BMC Cancer. 2024-2-21

引用本文的文献

[1]
First-line durvalumab therapy alone or in combination with tremelimumab for metastatic head and neck squamous cell carcinoma: A cost-effectiveness analysis.

PLoS One. 2025-5-16

[2]
Cost‑effectiveness analysis of tislelizumab plus chemotherapy in Chinese patients with advanced or metastatic oesophageal squamous cell carcinoma.

Sci Rep. 2024-7-31

[3]
First-line serplulimab plus chemotherapy versus chemotherapy in PD-L1-positive esophageal squamous-cell carcinoma: a cost-effectiveness analysis.

Sci Rep. 2024-6-24

[4]
Cost-effectiveness of additional serplulimab to chemotherapy in metastatic squamous non-small cell lung cancer patients.

Front Immunol. 2024

[5]
Cost-effectiveness analysis of durvalumab, tremelimumab, and etoposide-platinum in first-line treatment of extensive-stage small cell lung cancer.

Medicine (Baltimore). 2024-4-19

[6]
Nivolumab plus ipilimumab versus the EXTREME regimen in recurrent/metastatic squamous cell carcinoma of the head and neck: a cost-effectiveness analysis.

Sci Rep. 2024-3-21

[7]
Cost-effectiveness analysis of first-line serplulimab combined with chemotherapy for extensive-stage small cell lung cancer.

Front Public Health. 2023

[8]
Electrochemotherapy vs radiotherapy in the treatment of primary cutaneous malignancies or cutaneous metastases from primary solid organ malignancies: A systematic review and narrative synthesis.

PLoS One. 2023

[9]
Cost-effectiveness of cemiplimab plus chemotherapy versus chemotherapy for the treatment of advanced non-small cell lung cancer.

Front Oncol. 2023-4-26

[10]
Sugemalimab plus chemotherapy vs. chemotherapy for metastatic non-small-cell lung cancer: A cost-effectiveness analysis.

Front Public Health. 2023

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