Similarly, in patients with local or locoregional NSCLC, a high proportion deteriorate into recurrent or metastatic NSCLC ( 8– 10), and the prognosis in patients with distant metastatic NSCLC remains poor, with the 5-year survival data reported to be approximately 5% ( 1). Progression to advanced or metastatic cancer occurs in approximately 50% of NSCLC cases ( 1, 6, 7). Lung squamous and non-squamous cell carcinomas constitute 25-30% and 70-75% of NSCLC cases, respectively ( 1, 5). Lung cancer is generally divided into four histological categories, with non-small cell lung cancer (NSCLC) accounting for 85-90% of all lung cancers ( 3, 4). Because lung cancer is often diagnosed at an advanced stage, its prognosis is poor. Lung cancer is one of the most common types of carcinomas and the leading cause of cancer death ( 1), causing nearly 1.8 million deaths (18%) worldwide ( 2). Reducing the cost of pembrolizumab may lead to valuable outcomes. Subgroup analysis revealed that treatment with pembrolizumab was related to a higher INHB in several subgroups, including patients with brain metastases at baseline.Ĭonclusion: Our findings suggest that the WTP threshold should be considered when choosing between cemiplimab and pembrolizumab to treat advanced NSCLC with high PD-L1 expression. One-way sensitivity analysis indicated that the models were sensitive to pembrolizumab and cemiplimab costs. When the WTP threshold increased to $150,000/QALY, the INHB and INMB of pembrolizumab were 0.022 QALYs and $3,335, respectively, and the probability of pembrolizumab was 51.85%. At a willingness-to-pay (WTP) threshold of $100,000/QALY, INHB, and INMB of pembrolizumab were -0.013 QALYs and -$1,329, respectively, and the probability of cemiplimab was 51% when compared with pembrolizumab. The ICER in the PS model was similar to that in the Markov model, with a difference of $3,093/QALY. Results: Treatment of advanced NSCLC with high PD-L1 expression with pembrolizumab achieved 0.093 QALYs and was associated with an incremental cost of $10,657 compared with cemiplimab, yielding an ICER of $114,246/QALY. The robustness of the model was verified using one-way and probabilistic sensitivity analyses, and subgroup analyses were conducted. The main outcomes were overall costs, incremental cost-effectiveness ratios (ICERs), quality-adjusted life-years (QALYs), life-years, incremental net health benefits (INHB), and incremental net monetary benefits (INMB). A network meta-analysis including 2289 patients was constructed, and the Markov and partitioned survival (PS) models were used to assess the cost-effectiveness of pembrolizumab compared with that of cemiplimab for the treatment of high PD-L1 expression (≥50% of tumor cells). Materials and methods: Cost-effectiveness analysis integration of the network meta-analysis framework was performed using data from the EMPOWER-Lung 1, KEYNOTE 024, and KEYNOTE 042 phase 3 randomized clinical trials. This study aimed to evaluate the cost-effectiveness of pembrolizumab compared with that of cemiplimab in the treatment of advanced NSCLC with high PD-L1 expression from a societal perspective in the United States. 2School of Pharmaceutical Sciences, Guangxi Medical University, Nanning, Chinaīackground: Pembrolizumab and cemiplimab have been approved as treatment for advanced non-small-cell lung cancer (NSCLC) with high programmed death ligand-1 (PD-L1) expression.1Department of Pharmacy, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.Yan Li 1†, Xueyan Liang 1†, Tong Yang 1,2, Sitong Guo 1 and Xiaoyu Chen 1*
0 kommentar(er)
