First-line pembrolizumab plus chemotherapy for extensive-stage small-cell lung cancer: a United States-based cost-effectiveness analysis

Abstract Background The clinical trial of Keynote-604 showed that pembrolizumab plus chemotherapy could generate clinical benefits for extensive-stage small-cell lung cancer (ES-SCLC). We aim to assess the efficacy and cost of pembrolizumab combined with chemotherapy in the first-line treatment sett...

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Autores principales:	Youwen Zhu, Huabin Hu, Dong Ding, Shuosha Li, Mengting Liao, Yin Shi, Jin Huang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Pembrolizumab ES-SCLC Platinum-etoposide Cost-effectiveness Quality-adjusted life-years Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/fae3fec1da7f4facb34e366107f698eb
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spelling	oai:doaj.org-article:fae3fec1da7f4facb34e366107f698eb2021-12-05T12:19:43ZFirst-line pembrolizumab plus chemotherapy for extensive-stage small-cell lung cancer: a United States-based cost-effectiveness analysis10.1186/s12962-021-00329-w1478-7547https://doaj.org/article/fae3fec1da7f4facb34e366107f698eb2021-12-01T00:00:00Zhttps://doi.org/10.1186/s12962-021-00329-whttps://doaj.org/toc/1478-7547Abstract Background The clinical trial of Keynote-604 showed that pembrolizumab plus chemotherapy could generate clinical benefits for extensive-stage small-cell lung cancer (ES-SCLC). We aim to assess the efficacy and cost of pembrolizumab combined with chemotherapy in the first-line treatment setting of ES-SCLC from the United States (US) payers’ perspective. Methods A synthetical Markov model was used to evaluate cost and effectiveness of pembrolizumab plus platinum-etoposide(EP) versus EP in first-line therapy for ES-SCLC from the data of Keynote-604. Lifetime costs life-years(LYs), quality adjusted LYs(QALYs) and incremental cost-effectiveness ratios(ICERs) were estimated. One-way and probabilistic sensitivity analyses were performed. Furthermore, we performed subgroup analysis. Results Pembrolizumab plus EP resulted in additional 0.18 QALYs(0.32 LYs) and corresponding incremental costs $113,625, resulting an ICER of $647,509 per QALY versus EP. The price of pembrolizumab had a significant impact on ICER. Probabilistic sensitivity analysis indicated that pembrolizumab combined chemotherapy may become a cost-effective option with a probability of 0%. Besides, subgroup analysis suggested that all subgroups were not cost-effective. Conclusion From the perspective of the US payer, pembrolizumab plus EP is not a cost-effective option for first-line treatment patients with ES-SCLC at a WTP threshold of $150,000 per QALY.Youwen ZhuHuabin HuDong DingShuosha LiMengting LiaoYin ShiJin HuangBMCarticlePembrolizumabES-SCLCPlatinum-etoposideCost-effectivenessQuality-adjusted life-yearsMedicine (General)R5-920ENCost Effectiveness and Resource Allocation, Vol 19, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pembrolizumab ES-SCLC Platinum-etoposide Cost-effectiveness Quality-adjusted life-years Medicine (General) R5-920
spellingShingle	Pembrolizumab ES-SCLC Platinum-etoposide Cost-effectiveness Quality-adjusted life-years Medicine (General) R5-920 Youwen Zhu Huabin Hu Dong Ding Shuosha Li Mengting Liao Yin Shi Jin Huang First-line pembrolizumab plus chemotherapy for extensive-stage small-cell lung cancer: a United States-based cost-effectiveness analysis
description	Abstract Background The clinical trial of Keynote-604 showed that pembrolizumab plus chemotherapy could generate clinical benefits for extensive-stage small-cell lung cancer (ES-SCLC). We aim to assess the efficacy and cost of pembrolizumab combined with chemotherapy in the first-line treatment setting of ES-SCLC from the United States (US) payers’ perspective. Methods A synthetical Markov model was used to evaluate cost and effectiveness of pembrolizumab plus platinum-etoposide(EP) versus EP in first-line therapy for ES-SCLC from the data of Keynote-604. Lifetime costs life-years(LYs), quality adjusted LYs(QALYs) and incremental cost-effectiveness ratios(ICERs) were estimated. One-way and probabilistic sensitivity analyses were performed. Furthermore, we performed subgroup analysis. Results Pembrolizumab plus EP resulted in additional 0.18 QALYs(0.32 LYs) and corresponding incremental costs $113,625, resulting an ICER of $647,509 per QALY versus EP. The price of pembrolizumab had a significant impact on ICER. Probabilistic sensitivity analysis indicated that pembrolizumab combined chemotherapy may become a cost-effective option with a probability of 0%. Besides, subgroup analysis suggested that all subgroups were not cost-effective. Conclusion From the perspective of the US payer, pembrolizumab plus EP is not a cost-effective option for first-line treatment patients with ES-SCLC at a WTP threshold of $150,000 per QALY.
format	article
author	Youwen Zhu Huabin Hu Dong Ding Shuosha Li Mengting Liao Yin Shi Jin Huang
author_facet	Youwen Zhu Huabin Hu Dong Ding Shuosha Li Mengting Liao Yin Shi Jin Huang
author_sort	Youwen Zhu
title	First-line pembrolizumab plus chemotherapy for extensive-stage small-cell lung cancer: a United States-based cost-effectiveness analysis
title_short	First-line pembrolizumab plus chemotherapy for extensive-stage small-cell lung cancer: a United States-based cost-effectiveness analysis
title_full	First-line pembrolizumab plus chemotherapy for extensive-stage small-cell lung cancer: a United States-based cost-effectiveness analysis
title_fullStr	First-line pembrolizumab plus chemotherapy for extensive-stage small-cell lung cancer: a United States-based cost-effectiveness analysis
title_full_unstemmed	First-line pembrolizumab plus chemotherapy for extensive-stage small-cell lung cancer: a United States-based cost-effectiveness analysis
title_sort	first-line pembrolizumab plus chemotherapy for extensive-stage small-cell lung cancer: a united states-based cost-effectiveness analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/fae3fec1da7f4facb34e366107f698eb
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First-line pembrolizumab plus chemotherapy for extensive-stage small-cell lung cancer: a United States-based cost-effectiveness analysis

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