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Abstract：
UNASSIGNED: The combination of immune checkpoint inhibitors (ICIs) and chemotherapy is a promising first-line therapy for patients with advanced non-squamous non-small cell lung cancer (NSCLC). The cost-effectiveness of combinations with different ICIs is yet to be compared.
UNASSIGNED: We utilized Bayesian network meta-analyses for the comparisons of overall survival, progression-free survival, and incidence of adverse events of the included treatments in the total population and subgroups with different programmed death-ligand 1 tumor proportional scores (TPS). The cost-effectiveness of the treatments from the perspectives of the US and Chinese healthcare systems was assessed using Markov models.
UNASSIGNED: Three combinations, including pembrolizumab + chemotherapy (PembroC), nivolumab + ipilimumab + chemotherapy (NivoIpiC), and atezolizumab + chemotherapy (AteC), were included in our study. In terms of efficacy, PembroC was most likely to be ranked first for extending progression-free survival (PFS) (93.16%) and overall survival (OS) (90.73%). Nevertheless, from the US perspective, NivoIpiC and PembroC showed incremental cost-effectiveness ratios (ICERs) of $68,963.1/quality-adjusted life-years (QALY) and $179,355.6/QALY, respectively, compared with AteC. The one-way sensitivity analysis revealed that the results were primarily sensitive to the hazard ratios for OS or the cost of immunotherapy agents. At a willingness-to-pay (WTP) threshold of $150,000/QALY, NivoIpiC had the highest probability of being cost-effective (63%). As for the Chinese perspective, NivoIpiC and PembroC had ICERs of $145,983.4/QALY and $195,863.3/QALY versus AteC, respectively. The results were primarily sensitive to the HRs for OS. At a WTP threshold of $38,017/QALY, AteC had the highest probability of cost-effectiveness (94%).
UNASSIGNED: Although PembroC has the optimal efficacy, NivoIpiC and AteC were the most favorable treatments in terms of cost-effectiveness for patients with advanced non-squamous NSCLC from the US and Chinese perspectives, respectively.
UNASSIGNED: We utilized Bayesian network meta-analyses for the comparisons of overall survival, progression-free survival, and incidence of adverse events of the included treatments in the total population and subgroups with different programmed death-ligand 1 tumor proportional scores (TPS). The cost-effectiveness of the treatments from the perspectives of the US and Chinese healthcare systems was assessed using Markov models.
UNASSIGNED: Three combinations, including pembrolizumab + chemotherapy (PembroC), nivolumab + ipilimumab + chemotherapy (NivoIpiC), and atezolizumab + chemotherapy (AteC), were included in our study. In terms of efficacy, PembroC was most likely to be ranked first for extending progression-free survival (PFS) (93.16%) and overall survival (OS) (90.73%). Nevertheless, from the US perspective, NivoIpiC and PembroC showed incremental cost-effectiveness ratios (ICERs) of $68,963.1/quality-adjusted life-years (QALY) and $179,355.6/QALY, respectively, compared with AteC. The one-way sensitivity analysis revealed that the results were primarily sensitive to the hazard ratios for OS or the cost of immunotherapy agents. At a willingness-to-pay (WTP) threshold of $150,000/QALY, NivoIpiC had the highest probability of being cost-effective (63%). As for the Chinese perspective, NivoIpiC and PembroC had ICERs of $145,983.4/QALY and $195,863.3/QALY versus AteC, respectively. The results were primarily sensitive to the HRs for OS. At a WTP threshold of $38,017/QALY, AteC had the highest probability of cost-effectiveness (94%).
UNASSIGNED: Although PembroC has the optimal efficacy, NivoIpiC and AteC were the most favorable treatments in terms of cost-effectiveness for patients with advanced non-squamous NSCLC from the US and Chinese perspectives, respectively.
摘要：
■免疫检查点抑制剂（ICIs）和化学疗法的组合是晚期非鳞状非小细胞肺癌（NSCLC）患者的有希望的一线治疗方法。与不同ICI组合的成本效益尚待比较。
■我们使用贝叶斯网络荟萃分析来比较总生存期，无进展生存期,在具有不同程序性死亡-配体1肿瘤比例评分（TPS）的总人群和亚组中，所包括治疗的不良事件发生率。使用马尔可夫模型从美国和中国医疗保健系统的角度评估了治疗的成本效益。
■三种组合，包括pembrolizumab+化疗（PembroC），nivolumab+ipilimumab+化疗（NivoIpiC），阿替珠单抗+化疗（AteC），包括在我们的研究中。就功效而言,PembroC最有可能在延长无进展生存期（PFS）（93.16％）和总生存期（OS）（90.73％）方面排名第一。然而，从美国的角度来看,NivoIpiC和PembroC的增量成本效益比（ICER）为68,963.1美元/质量调整寿命年（QALY）和179,355.6美元/QALY，分别,与Atec相比。单向敏感性分析显示，结果主要对OS的风险比或免疫治疗剂的成本敏感。在支付意愿(WTP)门槛为$150,000/QALY时，NivoIpiC的成本效益最高(63%)。至于中国人的观点，NivoIpiC和PembroC的ICER为$145,983.4/QALY和$195,863.3/QALY，分别。结果主要对OS的HR敏感。WTP阈值为38,017美元/质量，AteC的成本效益概率最高(94%)。
■尽管PembroC具有最佳功效，从美国和中国的角度来看，就晚期非鳞状细胞肺癌患者的成本效益而言，NivoIpiC和AteC是最有利的治疗方法。分别。
■我们使用贝叶斯网络荟萃分析来比较总生存期，无进展生存期,在具有不同程序性死亡-配体1肿瘤比例评分（TPS）的总人群和亚组中，所包括治疗的不良事件发生率。使用马尔可夫模型从美国和中国医疗保健系统的角度评估了治疗的成本效益。
■三种组合，包括pembrolizumab+化疗（PembroC），nivolumab+ipilimumab+化疗（NivoIpiC），阿替珠单抗+化疗（AteC），包括在我们的研究中。就功效而言,PembroC最有可能在延长无进展生存期（PFS）（93.16％）和总生存期（OS）（90.73％）方面排名第一。然而，从美国的角度来看,NivoIpiC和PembroC的增量成本效益比（ICER）为68,963.1美元/质量调整寿命年（QALY）和179,355.6美元/QALY，分别,与Atec相比。单向敏感性分析显示，结果主要对OS的风险比或免疫治疗剂的成本敏感。在支付意愿(WTP)门槛为$150,000/QALY时，NivoIpiC的成本效益最高(63%)。至于中国人的观点，NivoIpiC和PembroC的ICER为$145,983.4/QALY和$195,863.3/QALY，分别。结果主要对OS的HR敏感。WTP阈值为38,017美元/质量，AteC的成本效益概率最高(94%)。
■尽管PembroC具有最佳功效，从美国和中国的角度来看，就晚期非鳞状细胞肺癌患者的成本效益而言，NivoIpiC和AteC是最有利的治疗方法。分别。
