KEY TAKEAWAYS
- This GEMSTONE-302, phase 3 trial assessed the cost-effectiveness of sugemalimab plus chemotherapy (SC) versus placebo plus chemotherapy (PC) as first-line treatment for patients with non-small cell lung cancer (NSCLC).
- From the Chinese healthcare perspective, a three-state Markov model was used to estimate the incremental cost-effectiveness ratio (ICER) of SC versus PC over a 10-year horizon.
- The primary outcomes included costs and health outcomes in quality-adjusted life-years (QALYs) and the ICER under a willingness-to-pay (WTP) threshold of $37,663/QALYs.
- Results showed that SC was not cost-effective compared to PC as a first-line treatment for NSCLC, regardless of PD-L1 tumor expression level and pathological subtype.
- Sensitivity analysis results suggested that the model outcomes were reliable.
The goal of this research was to compare the costs associated with using sugemalimab plus chemotherapy (SC) as first-line treatment for patients with non-small cell lung cancer (NSCLC) versus using a placebo plus chemotherapy (PC). To compare the ICER of SC versus PC as first-line treatment for patients with NSCLC over a 10-year horizon from the Chinese healthcare system’s perspective, a three-state Markov model with a cycle of 3 weeks was developed. In addition, the probability of time-dependent transition and safety information was gleaned from a phase 3 clinical trial conducted at many Chinese sites using a randomized, double-blind design (GEMSTONE-302).
Costs in US dollars, health outcomes measured in quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER) under a willingness-to-pay (WTP) threshold of $37,663/QALYs were the primary outcomes of the model. The model’s reliability was tested using deterministic, scenario, and probabilistic sensitivity analysis. First-line SC for the intention-to-treat (ITT) group acquired an additional 0.57 QALYs at an incremental cost of $62,404.15 compared to PC for a total cost-effectiveness ratio (ICER) of $109,480.97/QALY gained.
The ICER dropped to $52,327.02/QALY when PAPs were made available. When analyzed by subgroup, ICER values were higher than the WTP threshold regardless of whether or not PAP was included in the study. The model’s predictions appeared reliable, according to the sensitivity analysis results. Regardless of PD-L1 tumor expression level or pathological subtype, the SC was not cost-effective compared to PC when used as the first-line treatment for NSCLC in the Chinese healthcare system.
Source: https://pubmed.ncbi.nlm.nih.gov/36408023/
Clinical trial: https://clinicaltrials.gov/ct2/show/NCT03789604/
Li, W. and Wan, L. (2022). Cost-effectiveness analysis of sugemalimab vs. placebo, in combination with chemotherapy, for treatment of first-line metastatic NSCLC in China. Frontiers in Public Health, 10. doi:https://doi.org/10.3389/fpubh.2022.1015702.
