Saturday, June 22, 2024

Cost-Effectiveness of Tislelizumab Over Camrelizumab in Treating Advanced Esophageal Cancer in China

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The financial burden accompanying the treatment of esophageal squamous cell carcinoma (ESCC) in China is significant, especially for patients who have progressed following first-line chemotherapy or who cannot tolerate it. Tislelizumab, a selective PD-1 inhibitor, has demonstrated efficacy in treating locally advanced or metastatic ESCC. This study investigates the cost-effectiveness of tislelizumab compared to camrelizumab as a second-line treatment option in China, providing crucial insights into the economic benefits of adopting tislelizumab in clinical practice.

Study Methods

Employing a partitioned survival model from China’s healthcare system perspective, researchers analyzed the cost-effectiveness over a lifetime horizon in 3-week cycles. Individual patient data from the RATIONALE 302 trial and the ESCORT study were utilized to compensate for the absence of direct clinical trials. The study included only direct medical costs, with data sourced from local charges, published literature, and relevant databases. Sensitivity analyses and scenario analyses were conducted to ensure the robustness of the model outcomes.

Study Results

Tislelizumab monotherapy showed a lower lifetime cost ($8,346) compared to camrelizumab monotherapy ($8,851), while also delivering higher quality-adjusted life-years (QALYs) (0.87 vs. 0.63). This resulted in an incremental cost-effectiveness ratio (ICER) of -$2,051/QALY, making tislelizumab a dominant option. The parameters most influencing these findings were the unit costs of camrelizumab and tislelizumab, and the duration of reactive cutaneous capillary endothelial proliferation (RCCEP). Probabilistic sensitivity analysis (PSA) confirmed that tislelizumab was 100% cost-effective within the willingness-to-pay (WTP) range of 1-3 times GDP per capita in China ($11,207/QALY to $33,621/QALY).

Key Takeaways

– Tislelizumab offers a more cost-effective solution compared to camrelizumab for second-line treatment of advanced ESCC.
– The economic model’s robustness was confirmed through sensitivity and scenario analyses.
– The study specifically considered direct medical costs, ensuring practical relevance for healthcare policymakers.

In conclusion, tislelizumab monotherapy emerges as a superior financial and medical option over camrelizumab for treating locally advanced or metastatic ESCC in China. This finding underscores the importance of incorporating tislelizumab into the treatment regimen to enhance both patient outcomes and economic efficiency within the healthcare system.

Original Article: BMC Health Serv Res. 2024 May 29;24(1):676. doi: 10.1186/s12913-024-11142-5.

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