Zheng Zhiwei, Zhu Huide, Fang Ling
Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, China.
PLoS One. 2025 Jun 13;20(6):e0325171. doi: 10.1371/journal.pone.0325171. eCollection 2025.
This study aims to assess the cost-effectiveness of adebrelimab in combination with chemotherapy as a first-line treatment for extensive-stage small cell lung cancer (ES-SCLC) from the Chinese medical perspective.
We have designed a partitioned survival model. The model integrates clinical information pertaining to overall survival, progression-free survival, adverse events and cost data. Our primary measure of outcome in this model is quality-adjusted life years (QALY) and the incremental cost-effectiveness ratio (ICER). The model adopted a willingness to pay (WTP) threshold of $40,343.68 per QALY. To account for uncertainty in the model parameters, we conducted sensitivity analyses.
The total expenditure for the adebrelimab group was $79,549.34, compared to $6,436.80 for the chemotherapy group. The adebrelimab cohort achieved an incremental gain of 1.25 QALY, resulting in an additional cost of $73,112.54. Consequently, the ICER for the adebrelimab group was determined to be $58,490.03 per QALY, surpassing the WTP threshold of $40,343.68 in China. The sensitivity analyses demonstrated the robustness of the findings across various scenarios.
This cost-effectiveness analysis indicates that adebrelimab plus chemotherapy as a first-line treatment for ES-SCLC was not cost-effective in China with a WTP of $40,343.68.Reducing the cost of adebrelimab promises to improve the cost-effectiveness of this treatment regimen.
本研究旨在从中国医学角度评估阿得贝利单抗联合化疗作为广泛期小细胞肺癌(ES-SCLC)一线治疗方案的成本效益。
我们设计了一个分段生存模型。该模型整合了与总生存期、无进展生存期、不良事件及成本数据相关的临床信息。本模型的主要结局指标是质量调整生命年(QALY)和增量成本效益比(ICER)。该模型采用的支付意愿(WTP)阈值为每QALY 40343.68美元。为考虑模型参数的不确定性,我们进行了敏感性分析。
阿得贝利单抗组的总支出为79549.34美元,而化疗组为6436.80美元。阿得贝利单抗队列实现了1.25 QALY的增量收益,导致额外成本73112.54美元。因此,阿得贝利单抗组的ICER确定为每QALY 58490.03美元,超过了中国40343.68美元的WTP阈值。敏感性分析表明,在各种情况下研究结果都具有稳健性。
这项成本效益分析表明,在中国支付意愿为40343.68美元的情况下,阿得贝利单抗联合化疗作为ES-SCLC的一线治疗方案不具有成本效益。降低阿得贝利单抗的成本有望提高该治疗方案的成本效益。