Objective: This study evaluates the cost-effectiveness of tislelizumab plus chemotherapy as a first-line treatment for locally advanced or metastatic (IIIB/IV) nonsquamous non-small cell lung cancer (nsq-NSCLC) in China.
Methods: A Markov model projected health outcomes and costs over a lifetime, with health states including progression-free survival, progressive disease, terminal progressive disease (TPD) and death. Data came from a Chinese phase III trial. The primary outcome was quality-adjusted life years (QALYs), with incremental cost-effectiveness ratios (ICERs) calculated. Using sensitivity analysis to confirm the robustness of the results.
Results: The base-case analysis showed that tislelizumab combined chemotherapy group had 1.06 more QALYs (3.967 QALYs VS 2.909 QALYs) than the chemotherapy-alone group at an incremental cost of U.S. dollars ($) 19594.75 ($43390.52 VS $23795.77), resulting in an ICER of $18,512.47/QALY. This ICER is below the willingness-to-pay (WTP) threshold of three times China's 2023 per capita GDP ($36,672.23/QALY), indicating tislelizumab is economically favorable.
Conclusion: The conclusion is that tislelizumab combination therapy is a cost-effective first-line treatment option for nsq-NSCLC patients in China.
Keywords: Cost-effectiveness; Markov model; first-line treatment; non-small cell lung cancer; tislelizumab.
What is this article about?: Our study compared the cost and efficacy of the Immune checkpoint inhibitor tislelizumab combined with chemotherapy versus standard chemotherapy for the treatment of non-squamous non-small cell lung cancer. We wanted to know which treatment regimen performed better in terms of helping patients and saving medical costs. We examined the health improvements of patients after using each drug, as well as the total costs of these medications. What were the results?: We found that although tislelizumab combined with chemotherapy was more expensive, it helped patients improve their health status, resulting in better physical conditions. What do the results of the study mean?: This means that, despite the higher cost of tislelizumab combined with chemotherapy, it is worth it when considering the long-term health improvements for patients, and it is also good news for patients and insurance companies that pay for medical expenses. Our research also showed that tislelizumab combined with chemotherapy has some limitations, such as the potential for adverse reactions and leading to discontinuation of the treatment. Therefore, doctors need to consider the specific circumstances of the patient when deciding which medication to use. Overall, our study helps us better understand the costs and effects of the two drugs, which can assist doctors, patients, and policymakers in making wiser choices.