OBJECTIVES

The aim of this study was to evaluate the cost-effectiveness of durvalumab compared with Best supportive care（BSC）after chemoradiotherapy in patients with stage Ⅲ non-small cell lung cancer from the China health system perspective.

METHODS

A dynamic semi-Markov model was adopted to simulate life time, direct medical costs and QALYs. In the base case scenario, for patients with unresectable, stage Ⅲ non-small cell lung cancer whose disease has not progressed after platinum-based chemoradiation therapy, the treatment group would use durvalumab whereas the control group would use BSC. Clinical data and health utility were derived from Asia sub-population in the PACIFIC trial. Cost of drug acquisition, follow-up, medical service, inspection, terminal care and adverse event treatment were considered in this model. The cost of durvalumab was calculated based on retail prices and Patient Assistance Program.

RESULTS

In the base case, durvalumab can reduce the risk of disease progression in patients. Each patient can save an average of 58914.18 RMB in follow-up treatment and 117.22 RMB in terminal care. The durvalumab group yielded an additional 2.60 LYs and 2.37QALYs, causing an additional cost of 0.459 million RMB and 0.142 million RMB with and without PAP, so the ICER was 193898.00 RMB/QALY and 59938.08 RMB/QALY respectively.

CONCLUSIONS

This study demonstrated that durvalumab can improve the survival of patients with unresectable, stage Ⅲ non-small cell lung cancer whose disease has not progressed after platinum-based chemoradiation therapy and would be a cost-effective alternative at a willingness to pay (WTP) threshold of 212676 RMB.