Comparative cost-effectiveness of nivolumab first-line and second-line therapy for advanced esophageal cancer in Japan

Kashiwa, Munenobu

doi:10.1007/s10198-023-01602-w

Cited by 1 publication

(3 citation statements)

References 27 publications

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“… 25 , 58 Nivolumab and pembrolizumab were also unaffordable in other countries, including the United States and Japan. 59 Kashiwa 47 developed a partitioned survival model from the Japanese National Health Insurance payer perspective to forecast costs and outcomes associated with first-line and second-line nivolumab therapy for advanced oesophageal cancer. This study found that nivolumab could be recommended as first-line treatment in combination with chemotherapy but not as second-line monotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…This study found that nivolumab could be recommended as first-line treatment in combination with chemotherapy but not as second-line monotherapy. 47 Hu et al 60 demonstrated that, from a third-party public healthcare payer perspective in the United States, pembrolizumab was not an economically advantageous scheme in patients with PD-L1 combined positive score (CPS) ⩽10 OSCC or oesophageal adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

“… 46 The disutility values incurred for treatment-related AEs were obtained from the literature. 42 , 47 , 48 All model parameters are provided in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

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Immune checkpoint inhibitors versus chemotherapy as second-line therapy for advanced oesophageal squamous cell carcinoma: a systematic review and economic evaluation

Liu,

Dou,

2024

Therap Adv Gastroenterol

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Background: Recently, several novel programmed cell death protein 1 (PD-1) inhibitors have been approved for second-line treating advanced or metastatic oesophageal squamous cell carcinoma (OSCC), including camrelizumab, nivolumab, pembrolizumab, sintilimab and tislelizumab. However, the optimal treatment regimen remained ambiguous. Objectives: The purpose of this study was to investigate the efficacy, safety and economy of available PD-1 inhibitors to determine the optimal treatment from the Chinese healthcare system perspective. Design: A systematic review and economic evaluation. Data sources and methods: A systematic review was undertaken utilizing PubMed, Web of Science, Cochrane Library, Embase and Scopus databases to identify eligible studies until 31 August 2023. Primary outcomes were progression-free survival (PFS), overall survival (OS) and adverse events (AEs). We also developed a partitioned survival model at 3-week intervals based on five clinical trials to predict long-term costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios for various treatment options. Direct medical costs and utility values were obtained from public drug bidding databases, clinical trials or published literature. The parameter uncertainties within the model were determined via one-way and probabilistic sensitivity analyses. Results: Five randomized controlled trials involving 2837 patients were included in the analysis. Compared with other treatments examined, camrelizumab provided the best PFS benefits [hazard ratio (HR): 0.69, 95% confidence interval (CI): 0.56–0.86], and pembrolizumab provided the best OS benefits (HR: 0.55, 95% CI: 0.37–0.82). Nivolumab caused a relatively lower incidence of treatment-related AEs (HR: 0.10, 95% CI: 0.05–0.20) and grade 3–5 AEs (HR: 0.13, 95% CI: 0.08–0.21) than other immunotherapy regimens. In the economic evaluation, average 10-year costs ranged from $5,433.86 (chemotherapy) to $50,617.95 (nivolumab) and mean QALYs ranged from 0.55 (chemotherapy) to 0.82 (camrelizumab). Pembrolizumab was eliminated because of dominance. Of the remaining strategies, when the willingness-to-pay thresholds were 1, 2 and 3 times GDP per capita in 2022, sintilimab, tislelizumab and camrelizumab were the most cost-effective treatment options, respectively. Conclusion: Sintilimab might be the optimal treatment alternative for second-line therapy of advanced OSCC in China, followed by tislelizumab and camrelizumab. Trial registration: This study has been registered on the PROSPERO database with the registration number CRD42023495204.

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