A recent study highlights the economic viability of combining benmelstobart and anlotinib with etoposide-carboplatin (EC) for treating extensive-stage small-cell lung cancer (ES-SCLC), demonstrating significant survival benefits in the United States while revealing affordability issues in China.
US Market Analysis
In the United States, the combination therapy of benmelstobart and anlotinib with EC achieved an incremental cost-effectiveness ratio (ICER) of $121,560.40 per quality-adjusted life year (QALY) compared to EC alone, and $127,579.09/QALY versus anlotinib plus EC. These figures fall below the higher willingness-to-pay (WTP) threshold of $150,000/QALY, indicating that the treatment is economically justifiable for US healthcare payers. However, to meet the more stringent $100,000/QALY threshold, a price reduction for benmelstobart to $1316.12 per 600 mg dose is necessary.
Chinese Market Analysis
Contrastingly, in China, the ICER stands at $117,667.17/QALY, exceeding the local WTP threshold of $40,011/QALY. Price adjustments are essential for cost-effectiveness, with benmelstobart needing to be priced below $328.47 per 600 mg dose. This substantial price reduction underscores the financial barriers within the Chinese healthcare system for adopting this combination therapy.
• Benmelstobart pricing significantly influences cost-effectiveness
• Progression-free survival (PFS) utility plays a critical role in economic evaluations
• US market shows higher acceptance at elevated WTP thresholds
• China requires considerable price adjustments to align with local affordability
The study utilized a partitioned survival model based on the ETER701 trial, incorporating direct medical costs and health utilities from various sources. Sensitivity analyses revealed that both PFS utility and drug pricing are pivotal factors affecting the overall cost-effectiveness of the treatment regimen.
Probabilistic analyses further supported these findings, showing a 75.1% probability of the combination therapy being cost-effective in the US at the $150,000/QALY threshold. However, the probability dropped to 0% at lower WTP thresholds in both the US and China, emphasizing the need for strategic pricing adjustments.
The economic evaluation suggests that while the benmelstobart and anlotinib combination presents a promising treatment option for ES-SCLC patients in the US, its high cost poses a significant barrier in China. Addressing these pricing disparities is crucial for enhancing patient access and ensuring the sustainability of healthcare systems.
Strategic policy interventions to regulate drug pricing and reimbursement frameworks could bridge the affordability gap, particularly in price-sensitive markets like China. Furthermore, ongoing negotiations between pharmaceutical companies and healthcare providers will be essential to balance clinical benefits with economic sustainability, ultimately improving outcomes for ES-SCLC patients globally.
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