First-line atezolizumab plus chemotherapy in advanced non-squamous non-small cell lung cancer: a cost-effectiveness analysis from China. (3rd September 2021)

• Record Type: Journal Article
• Authors: Yang, Zhiguang; Zhu, Yumei; Xiang, Guiyuan; Hua, Tiantian; Ni, Jun; Zhao, Jie; Lu, Yun; Wu, Yingyu; Chang, Feng
• Is Part Of: Expert review of pharmacoeconomics & outcomes research. Volume 21:Number 5(2021)
• Page Start: 1061
• Page End: 1067
• Publication Date: 2021-09-03
• Subjects: Cost-effectiveness -- non-small cell lung cancer -- atezolizumab -- Markov model -- China; Pharmacology -- Economic aspects -- Periodicals; 338.47615105
• DOI: 10.1080/14737167.2021.1899813
• Languages: English
• ISSNs: 1473-7167

Abstract

ABSTRACT: Objective : To assess the cost-effectiveness of atezolizumab in combination with carboplatin plus nab-paclitaxel-based chemotherapy versus chemotherapy alone for first-line treatment of advanced non-squamous non-small cell lung cancer (NSCLC) from the Chinese healthcare system perspective. Methods : A Markov model was developed based on the IMpower130 clinical trial. Drug costs and health state utility were obtained from the literature. Outcomes included life-years (LYs), quality-adjusted life-years (QALYs), lifetime costs, and incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were performed to evaluate the model uncertainty. Results : When compared to chemotherapy alone, atezolizumab plus chemotherapy provides an additional 0.34 LY and 0.19 QALY, and has an ICER of $180, 560.15 per additional LY gained and that of $325, 328.71 per QALY gained. Sensitivity analysis revealed that the results were most sensitive to changes in atezolizumab cost. Probabilistic sensitivity analysis showed that there was a 0% probability that atezolizumab plus chemotherapy was cost-effective at willingness-to-pay values of $30, 828 per QALY. If the WTP threshold increased to $325, 000 per QALY, atezolizumab plus chemotherapy has a 50% chance to be cost-effective. Conclusions : From the Chinese healthcare system perspective, atezolizumab combination is not cost-effective for first-line therapy of advanced non-squamous NSCLC.