Yan Chunyan, Li Zhengxiong, Li Jiayan, Zhao Quan, Cao Wenxiu, Li Shuqing, Diao Ruigang
Department of Pharmacy, Yantai Yuhuangding Hospital, Yantai, China.
School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, 221004, China.
Sci Rep. 2025 Mar 24;15(1):10147. doi: 10.1038/s41598-025-91540-9.
The results of the ETER701 trial showed that benmelstobart and anlotinib plus chemotherapy have potential advantages in the treatment of extensive small cell lung cancer (ES-SCLC). However, it must be noted that the high cost cannot be ignored. This study was designed to assess the cost-effectiveness of benmelstobart (B) and anlotinib (A) plus etoposide and carboplatin (EC) as first-line treatment options for patients with ES-SCLC in China. From the perspective of Chinese healthcare system, a three-state partitioned survival model was employed. The cycle length was set at three weeks, and the time horizon of the study was set as lifetime horizon. Total costs, life years (LYs), quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) as primary outputs of the model. Among them, the cost, and utility values were respectively derived from the YAOZHI database, and published literature on the subject. At the same time, in order to assess the impact of parameter uncertainty on the model outputs, scenario and sensitivity analyses were carried out. The results showed that compared with the EC group, the ICER for the B + A + EC group was $141,623.44/QALY, and the ICER for the A + EC group was $45,353.46/QALY, which were both higher than the willingness-to-pay (WTP) threshold ($38,024.68/QALY). Sensitivity analysis verified the robustness of the model. Scenario analysis showed that charitable donations and cut-price could raise the likelihood of being cost-effective for benmelstobart and anlotinib. B + A + EC and A + EC are considered unlikely to be cost-effective strategies for first-line treatment of ES-SCLC in China. However, reducing the costs of benmelstobart and anlotinib may enhance the cost-effectiveness of these treatment regimens.
ETER701试验结果表明，苯美司他巴特和安罗替尼联合化疗在广泛期小细胞肺癌（ES-SCLC）治疗中具有潜在优势。然而，必须指出的是，高昂的成本不容忽视。本研究旨在评估在中国，苯美司他巴特（B）和安罗替尼（A）联合依托泊苷和卡铂（EC）作为ES-SCLC患者一线治疗方案的成本效益。从中国医疗体系的角度出发，采用了三状态分区生存模型。周期长度设定为三周，研究的时间范围设定为终身范围。模型的主要输出包括总成本、生命年（LYs）、质量调整生命年（QALYs）和增量成本效益比（ICERs）。其中，成本和效用值分别来自药智数据库以及该主题的已发表文献。同时，为评估参数不确定性对模型输出的影响，进行了情景分析和敏感性分析。结果显示，与EC组相比，B+A+EC组的ICER为141,623.44美元/QALY，A+EC组的ICER为45,353.46美元/QALY，均高于支付意愿（WTP）阈值（38,024.68美元/QALY）。敏感性分析验证了模型的稳健性。情景分析表明，慈善捐赠和降价可以提高苯美司他巴特和安罗替尼具有成本效益的可能性。B+A+EC和A+EC被认为不太可能是中国ES-SCLC一线治疗的成本效益策略。然而，降低苯美司他巴特和安罗替尼的成本可能会提高这些治疗方案的成本效益。
