Cost Effectiveness of Tislelizumab Versus Chemotherapy as Second-Line Treatment for Advanced or Metastatic Esophageal Squamous Cell Carcinoma in China

OBJECTIVES:

The latest RATIONALE-302 trial (NCT03430843) showed that second-line tislelizumab therapy benefits patients with advanced or metastatic esophageal squamous cell carcinoma (ESCC) more than traditional chemotherapy. This study aimed to compare the cost-effectiveness of tislelizumab versus chemotherapy as a second-line treatment for advanced or metastatic ESCC in China.

METHODS:

From the perspective of Chinese healthcare payers, a partitioned survival model was developed to predict cost,quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). We extracted efficacy and safety data from the RATIONALE-302 trial and the local cost and resource use data from online databases and published studies. Both One-way sensitivity and probability sensitivity analyses(PSA) were performed to verify the robustness of the model results.

RESULTS:

Compared with chemotherapy, tislelizumab incurred a higher cost (US$ 10211.78 vs. US$ 7294.72) but yielded more QALY (0.78 vs. 0.51 QALYs). The ICER for tislelizumab was US$11073.85 per QALY gained. The PSA results indicated that the probability of tislelizumab being cost-effective was 76% under a willingness-to-pay threshold of 1.5 times per capita GDP in China.

CONCLUSIONS:

Tislelizumab could be a promising cost-effective strategy as the second-line treatment for patients with advanced or metastatic ESCC compared with chemotherapy in the Chinese setting.