Durvalumab consolidation therapy in patients with stage III non-small cell lung cancer after concurrent chemoradiation: a China-based cost-effectiveness analysis. (19th May 2022)

• Record Type: Journal Article
• Authors: Chen, Xuan; Yang, Zhiguang; Xiang, Guiyuan; Gu, Lingna; Qi, Ziheng; Wan, Bin; Lu, Yun; Chang, Feng; Zhu, Yumei
• Is Part Of: Expert review of pharmacoeconomics & outcomes research. Volume 22:Number 4(2022)
• Page Start: 647
• Page End: 654
• Publication Date: 2022-05-19
• Subjects: Durvalumab -- non-small cell lung cancer -- cost-effectiveness -- consolidation therapy -- China; Pharmacology -- Economic aspects -- Periodicals; 338.47615105
• DOI: 10.1080/14737167.2022.1993062
• Languages: English
• ISSNs: 1473-7167

Abstract

ABSTRACT: Objective: To evaluate the cost-effectiveness of durvalumab in post-chemoradiotherapy patients with unresectable stage III NSCLC from the Chinese healthcare system perspective. Methods: The study developed a five-health state Markov model to evaluate the cost-effectiveness of durvalumab consolidation therapy in post-chemoradiotherapy patients based on the PACIFIC clinical trial. Sensitivity and scenario analyses were performed to evaluate the model uncertainty. Results: Durvalumab consolidation therapy provided an additional 1.22 quality-adjusted life-years (QALYs), with an incremental cost of $24, 397 compared to no consolidation therapy in unselected patients. Durvalumab consolidation therapy was cost-effective as it yielded an incremental cost-effectiveness ratio (ICER) of $20, 000 per QALY gained at a willingness-to-pay (WTP) threshold of $31, 494 per QALY. In the patient subgroup with PD-L1-expressing tumors (≥1%), durvalumab was associated with an ICER of $33, 058/QALY, resulting in a slight skewing away from the given cost-effectiveness threshold. The sensitivity analysis showed that ICERs were most sensitive to the cost of durvalumab, the cost of pembrolizumab, and the body weight of patients, regardless of PD-L1 expression selection. Conclusion: Durvalumab consolidation therapy is likely to be cost-effective in China, which indicates that expensive immunotherapies can gain clinical benefits at a justifiable cost in developing countries as well.