Cost-effectiveness analysis of dostarlimab plus chemotherapy versus pembrolizumab plus chemotherapy as first-line treatment of metastatic non-squamous non-small cell lung cancer

Lung cancer is one of the most common malignant cancers in most countries, and non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. Checkpoint inhibitor immunotherapy is the preferred therapy for metastatic NSCLC patients who do not exhibit EGFR exon 19 deletion or L858R or ALK, RET, or ROS1 rearrangements. A recent clinical study (PERLA, NCT04581824) reports that dostarlimab has comparable effectiveness to pembrolizumab and presents clinical reliability as a first-line treatment for patients with metastatic non-squamous NSCLC. Our study employed a partitioned survival model (PSM) to evaluate the cost-effectiveness of dostarlimab plus chemotherapy compared to pembrolizumab plus chemotherapy as a first-line treatment of metastatic NSCLC from the perspective of healthcare payers in China. We found that when the time horizon was 10 years, dostarlimab plus chemotherapy was not cost-effective at the willingness to pay (WTP) threshold of 287,247 Chinese yuan (CNY)/QALY (35,057 EUR/QALY at an exchange rate of 1 CNY = 0.122 EUR).