OBJECTIVES: To determine the cost-effectiveness of cancer drugs and begin uncovering the WTP threshold in the U.S. Immunotherapy for stage IV ES-SCLC was used as the example.

METHODS: Trial-based cost-effectiveness using a microsimulation disease model. Cost estimates from Medicare in-patient rates to represent the patient population and because of reimbursement rate transparency.

RESULTS: Cost per QALY was $323,730.16, $1,051,910.02, $646,877.85 (min, max, mean) for serplulimab and $172,813.59, $1,162,387.93, $593,339.82 for the control regimen. ICER was estimated to be -$381,674.41, $723,975.30, $172,705.35 per QALY due to the low drug cost of generic chemotherapy and incremental benefit in clinical outcomes observed in the study. Serplulimab was found to be a dominant intervention in 34.5% of simulations compared to chemotherapy to treat ES-SCLC. Results of the comparative effectiveness analysis (CEA) are discussed in the poster.

CONCLUSIONS: Despite the high ICER observed in this study, access to cancer drugs in the U.S. is typically not affected. The most impactful factors identified were the hospital where a patient is treated, healthcare resources used to treat the patient (major complications case used), and the health utility state.