A cost-effectiveness analysis of first-line toripalimab plus chemotherapy in advanced nonsquamous non-small cell lung cancer in China

ABSTRACTBackground This study compares first-line toripalimab with chemotherapy for advanced nonsquamous non-small cell lung cancer (NSCLC) from the perspective of the Chinese healthcare system.Research design and methods A three-state Markov model was established to compare the quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER) of first-line toripalimab plus chemotherapy versus chemotherapy. Clinical outcomes data were acquired from the CHOICE-01 clinical trials. Costs and utilities were gathered from regional databases or published publications. One-way sensitivity and probability sensitivity analyses were used to investigate the stability of the model parameters.Results First-line toripalimab treatment for advanced nonsquamous NSCLC resulted in an incremental cost of $16,214.03 and added 0.77 QALYs compared to chemotherapy, which had an ICER of $21,057.18 per QALY gained. The ICER was substantially lower than the willingness to pay (WTP) threshold in China, which was $37,663.26 per QALY. The toripalimab cycle used was shown to have the greatest impact on the ICERs, according to sensitivity analysis, although none of the factors significantly affected the model's outcomesConclusions Toripalimab plus chemotherapy is likely to be a cost-effective option compared with chemotherapy alone for patients with advanced nonsquamous NSCLC from the perspective of the Chinese healthcare system.KEYWORDS: cost-effectivenessnonsquamousnon-small-cell lung cancertoripalimabchemotherapy Declaration of interestsThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Ethics statementOur cost-effectiveness analysis was based on previously published research and computer modeling methodologies. The study did not require permission from a hospital research ethics board.Author contributionsThe investigation was under supervision and carried out by H Cai and Z Zheng. The article was written and modified by Z Zheng. G Zhu provided assistance with statistical analysis. X Cao performed a software analysis. H Zhu assisted with the data collection.Data availability statementData are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.Supplementary materialSupplemental data for this article can be accessed online at https://doi.org/10.1080/17512433.2023.2188194Additional informationFundingThis work was supported by Shantou Science and Technology Project (Grant No. (2022)81-132).