COST-EFFECTIVENESS ANALYSIS OF DURVALUMAB AS FIRST-LINE TREATMENT FOR NON-SMALL CELL LUNG CANCER IN JAPAN
Author(s)
Seiya Taniguchi, MS1, Shota Suzuki, BS1, Ryutaro Sakai, MS1, Mao Yamaguchi, MS1, Kensuke Moriwaki, BS, MS, PhD2.
1Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan University, Kyoto, Japan.
1Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan University, Kyoto, Japan.
OBJECTIVES: In the MYSTIC trial, durvalumab monotherapy and durvalumab plus tremelimumab combination therapy were evaluated against chemotherapy for metastatic non-small cell lung cancer (NSCLC). However, given the high costs of these therapies, their economic value remains unclear. This study aimed to evaluate the cost-effectiveness of durvalumab-based therapies compared with chemotherapy from the perspective of the Japanese public healthcare payer.
METHODS: A partitioned survival analysis model was developed to estimate costs and quality-adjusted life years (QALYs) for three strategies. Survival data were obtained from the MYSTIC trial. Drug costs were based on the Japanese national drug price standard. Other cost parameters were derived from analyses of the JMDC claims database. Utility weights were obtained from published literature. The incremental cost-effectiveness ratios (ICERs) were estimated, and sensitivity analyses were conducted to assess parameter uncertainty.
RESULTS: Durvalumab plus tremelimumab was dominated, being more costly and less effective than both chemotherapy and monotherapy. Durvalumab monotherapy resulted in an incremental cost of JPY 6,072,065 and an incremental gain of 0.79 QALYs compared with chemotherapy, yielding an ICER of JPY 7,663,268/QALY. Deterministic sensitivity analysis showed the progression-free state utility had the greatest impact on the ICER. Probabilistic sensitivity analysis indicated the probability of durvalumab being cost-effective was 96.4% at a willingness-to-pay threshold of JPY 15 million/QALY.
CONCLUSIONS: At a JPY 15 million/QALY threshold, durvalumab monotherapy was cost-effective compared with chemotherapy for metastatic NSCLC, whereas the combination therapy with tremelimumab was not. These findings provide critical evidence for pricing strategies and healthcare policy decision-making.
METHODS: A partitioned survival analysis model was developed to estimate costs and quality-adjusted life years (QALYs) for three strategies. Survival data were obtained from the MYSTIC trial. Drug costs were based on the Japanese national drug price standard. Other cost parameters were derived from analyses of the JMDC claims database. Utility weights were obtained from published literature. The incremental cost-effectiveness ratios (ICERs) were estimated, and sensitivity analyses were conducted to assess parameter uncertainty.
RESULTS: Durvalumab plus tremelimumab was dominated, being more costly and less effective than both chemotherapy and monotherapy. Durvalumab monotherapy resulted in an incremental cost of JPY 6,072,065 and an incremental gain of 0.79 QALYs compared with chemotherapy, yielding an ICER of JPY 7,663,268/QALY. Deterministic sensitivity analysis showed the progression-free state utility had the greatest impact on the ICER. Probabilistic sensitivity analysis indicated the probability of durvalumab being cost-effective was 96.4% at a willingness-to-pay threshold of JPY 15 million/QALY.
CONCLUSIONS: At a JPY 15 million/QALY threshold, durvalumab monotherapy was cost-effective compared with chemotherapy for metastatic NSCLC, whereas the combination therapy with tremelimumab was not. These findings provide critical evidence for pricing strategies and healthcare policy decision-making.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE96
Topic
Economic Evaluation
Disease
SDC: Oncology