COST-EFFECTIVENESS ANALYSIS OF DURVALUMAB CONSOLIDATION TREATMENT AFTER CHEMORADIOTHERAPY FOR PATIENTS WITH LIMITED-STAGE SMALL-CELL LUNG CANCER IN JAPAN...
Author(s)
Kishiohji Kohki, MS1, Ryutaro Sakai, MS2, Kensuke Moriwaki, PhD3.
1Rirsumeikan University, kusatsu, Japan, 2Ritsumeikan University, Kusatsu, Japan, 3Ritsumeikan University, Kyoto, Japan.
1Rirsumeikan University, kusatsu, Japan, 2Ritsumeikan University, Kusatsu, Japan, 3Ritsumeikan University, Kyoto, Japan.
OBJECTIVES: Limited-stage small-cell lung cancer (SCLC) is commonly treated with concurrent chemoradiotherapy when surgery is not feasible. Although the ADRIATIC trial has reported that durvalumab maintenance therapy is efficacious in patients with limited-stage SCLC, its cost-effectiveness remains uncertain. This study aimed to evaluate the cost-effectiveness of durvalumab maintenance therapy after concurrent chemoradiotherapy for limited-stage SCLC from the perspective of the Japanese healthcare system.
METHODS: A partitioned survival analysis model was developed to estimate costs and quality-adjusted life years (QALYs) associated with durvalumab maintenance therapy following concurrent chemoradiotherapy for SCLC. The model included three health states: progression-free survival (PFS), progressed disease, and death. The incremental cost-effectiveness ratio (ICER) of durvalumab maintenance therapy compared with standard treatment without maintenance therapy was estimated. Sensitivity analyses were conducted to assess parameter uncertainty.
RESULTS: Durvalumab maintenance therapy resulted in an incremental cost of 16,368,526 JPY and gained 1.01 QALYs compared with placebo, yielding an ICER of 16,142,942 JPY/QALY. Durvalumab prolonged PFS by approximately 18 months relative to placebo. Deterministic sensitivity analysis indicated that the utility weight of PFS in the durvalumab group was the most influential parameter. Sensitivity analysis showed that the probability of being cost-effective was 43.3% at a willingness-to-pay (WTP) threshold of 15 million JPY/QALY, and a price reduction of 8.1% would be required for the ICER to fall below this threshold.
CONCLUSIONS: At a WTP threshold of 15 million JPY/QALY and based on the current drug pricing, durvalumab maintenance therapy was not considered cost-effective for limited-stage SCLC in Japan. However, a discount on the monthly drug cost would enable the therapy to meet the standard cost-effectiveness threshold, suggesting its potential value with appropriate pricing adjustments.
METHODS: A partitioned survival analysis model was developed to estimate costs and quality-adjusted life years (QALYs) associated with durvalumab maintenance therapy following concurrent chemoradiotherapy for SCLC. The model included three health states: progression-free survival (PFS), progressed disease, and death. The incremental cost-effectiveness ratio (ICER) of durvalumab maintenance therapy compared with standard treatment without maintenance therapy was estimated. Sensitivity analyses were conducted to assess parameter uncertainty.
RESULTS: Durvalumab maintenance therapy resulted in an incremental cost of 16,368,526 JPY and gained 1.01 QALYs compared with placebo, yielding an ICER of 16,142,942 JPY/QALY. Durvalumab prolonged PFS by approximately 18 months relative to placebo. Deterministic sensitivity analysis indicated that the utility weight of PFS in the durvalumab group was the most influential parameter. Sensitivity analysis showed that the probability of being cost-effective was 43.3% at a willingness-to-pay (WTP) threshold of 15 million JPY/QALY, and a price reduction of 8.1% would be required for the ICER to fall below this threshold.
CONCLUSIONS: At a WTP threshold of 15 million JPY/QALY and based on the current drug pricing, durvalumab maintenance therapy was not considered cost-effective for limited-stage SCLC in Japan. However, a discount on the monthly drug cost would enable the therapy to meet the standard cost-effectiveness threshold, suggesting its potential value with appropriate pricing adjustments.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE97
Topic
Economic Evaluation
Disease
SDC: Oncology