RATIONALE-306研究表明,晚期或转移性食管鳞状细胞癌(OSCC)患者可以从tisleizumab联合化疗治疗中受益。本研究旨在从中国医疗系统的角度评估tislelizumab联合化疗治疗OSCC的成本效益。分区生存模型使用RATIONAL-306数据评估了tislelizumab联合化疗与单独化疗治疗OSCC的成本效益。成本和公用事业是从当地数据库和已发表的研究中获得的。Costs,质量调整寿命年(QALYs),生命年,增量成本效益比(ICER),增量净健康福利(INHB),和增量净货币收益(INMB)是结果。价格模拟是在支付意愿(WTP)阈值下进行的。进行敏感性和亚组分析以评估模型的稳健性。与单纯化疗相比,tislelizumab加化疗的ICER为27,896美元/QALY,获得了额外的0.414QALY和0.751寿命年,并增加了11,560美元的费用。概率敏感性分析显示,在WTP为38,258美元/QALY时,tislelizumab联合化疗具有成本效益,概率为94.43%。当中国的价格低于3.714美元/毫克时,价格模拟结果表明,在38,258美元的WTP阈值下,tislelizumab联合化疗具有成本效益.Tislelizumab联合化疗产生的INHB为0.112QALYs和INMB为4,279美元,而WTP阈值为38,258美元的单独化疗。根据敏感性分析,以上结果稳定。对于具有更好的生存效益的亚组,观察到了总体趋势,这与成本效益的可能性更高有关。从中国医疗保健的角度来看,作为OSCC的一线治疗,tislelizumab联合化疗比单纯化疗更具成本效益.这些发现可以帮助临床医生做出最佳的临床决策,并帮助决策者评估tislelizumab在临床实践中的成本效益。
The RATIONALE-306 study revealed that patients with advanced or metastatic oesophageal squamous cell carcinoma (OSCC) could benefit from treatment with
tislelizumab plus chemotherapy. This study aimed to evaluate the cost-effectiveness of
tislelizumab plus chemotherapy for treating OSCC from the perspective of the Chinese healthcare system. Partitioned survival model estimated the cost-effectiveness of
tislelizumab plus chemotherapy compared with chemotherapy alone for treating OSCC using RATIONALE-306 data. Costs and utilities were obtained from local databases and published studies. Costs, quality-adjusted life-years (QALYs), life-years, incremental cost-effectiveness ratios (ICER), incremental net health benefits (INHB), and incremental net monetary benefits (INMB) were outcomes. Price simulation were conducted at the willingness-to-pay (WTP) threshold. Sensitivity and subgroup analyses were performed to assess model robustness. Compared with chemotherapy alone,
tislelizumab plus chemotherapy yielded an ICER of USD 27,896/QALY, gained an additional 0.414 QALYs and 0.751 life-years, and increased the cost by USD 11,560. Probabilistic sensitivity analysis revealed that
tislelizumab plus chemotherapy was cost-effective at the WTP of USD 38,258/QALY with probability of 94.43%. When the price in China was less than USD 3.714 per mg, the price simulation results indicated that tislelizumab plus chemotherapy was cost-effective at a WTP threshold of USD 38,258. Tislelizumab plus chemotherapy yielded an INHB of 0.112 QALYs and an INMB of USD 4,279 compared with chemotherapy alone at a WTP threshold of USD 38,258. Based on the sensitivity analyses, the above results were stable. A general trend was observed for subgroups with better survival benefits related to a higher probability of cost-effectiveness. From the Chinese healthcare perspective, tislelizumab plus chemotherapy is more cost-effective than chemotherapy alone as a first-line therapy for OSCC. These findings can help clinicians make optimal clinical decisions and assist decision-makers in evaluating the cost-effectiveness of tislelizumab in clinical practice.