Cost-Effectiveness Analysis of Camrelizumab As the Second-LINE Therapy for Advanced or Metastatic Esophageal Squamous Cell Carcinoma in Mainland China
Author(s)
Yang F, Fu Y, Chen M
Nanjing Medical University, Nanjing, China
OBJECTIVES Esophageal squamous cell carcinoma (ESCC) is the fourth most common cause of cancer-related death in Chinese population. According to a recent phase Ⅲ clinical trial (Clinicaltrials.gov, NCT03099382), camrelizumab has been demonstrated to improve overall survival in patients with advanced or metastatic ESCC compared to traditional chemotherapy. To our knowledge, no economic evaluation of camrelizumab in the Chinese context has been conducted. The study aimed to investigate the cost-effectiveness of camrelizumab versus chemotherapy as the second-line treatment for advanced or metastatic ESCC in China. METHODS A partitioned survival model was constructed in Microsoft Excel to integrate clinical and economic data in a hypothetical cohort of advanced or metastatic ESCC patients with a five-year time horizon. Input data was derived from published literature and expert opinion. Costs were estimated from the perspective of Chinese healthcare system. The Weibull distribution was employed to fit the transition probabilities extracted from the Kaplan-Meier curves. Univariate and probabilistic sensitivity analysis were conducted. RESULTS In the base-case analysis, camrelizumab increased cost and health outcome by $30728 and 0.28 QALYs, resulting in an ICER of $108605 per QALY gained, which was far above the willingness-to-pay threshold ($30094/QALY). Probabilistic sensitivity analysis showed that camrelizumab was not cost-effective. The cost of camrelizumab was found to be the determining factor in univariate sensitivity analysis. CONCLUSIONS Compared to chemotherapy, camrelizumab is not a cost-effective option because of its high cost in China.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PDG13
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Drugs, Oncology