Pcn236 a Landmark Response Analysis to Determine Cost-Effectiveness of Third-Line Nivolumab Monotherapy for Small Cell Lung Cancer

Smare, Caitlin; Dave, K; Juarez-Garcia, A.; Schoenherr, N.; Abraham, Pranav; Penrod, John R.; Camidge, D. Ross; Yuan, Yong

doi:10.1016/j.jval.2019.09.431

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“…Studies on cost-effectiveness of therapy for SCLC are limited. Smare et al reported that the ICER was $111,054/QALY for nivolumab versus IV topotecan and $73,110/QALY versus oral topotecan, and nivolumab was considered cost-effective for third-line treatment of SCLC in the USA [ 26 ]. However, nivolumab has not received approval for the indication of SCLC in China, and whether it is a worthwhile choice still needs to be explored.…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Anlotinib as Third- or Further-Line Treatment for Relapsed Small Cell Lung Cancer (SCLC) in China

et al. 2021

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Introduction The survival of patients with relapsed small cell lung cancer (SCLC) has achieved little progress in the last several decades. ALTER1202 confirmed the efficacy and safety of anlotinib as a third- or further-line option for relapsed SCLC. This study aimed to assess the cost-effectiveness of anlotinib compared with placebo as third- or further-line treatment for advanced SCLC in China. Methods A Markov model was developed to simulate the process of advanced SCLC and estimate the incremental cost-effectiveness ratio (ICER) of anlotinib versus placebo. The health outcomes and utilities were derived from the ALTER1202 (NCT03059797) and published sources, respectively. Total costs were calculated from the perspective of Chinese society. One-way and probabilistic sensitivity analyses (PSA) were conducted to explore the model uncertainties. Results Anlotinib was estimated to result in an additional 0.12 quality-adjusted life-years (QALYs) at an incremental cost of $2131.32, resulting in an ICER of $17,741.94/QALY. The ICER did not exceed the willingness-to-pay (WTP) threshold of $30,833 per QALY, which was three times the gross domestic product (GDP) per capita of China in 2019. One-way sensitivity analysis showed that the cost of anlotinib exerted the maximum influence on the result of the model, followed by the utility of progression-free survival (PFS) state in the anlotinib group and median overall survival (mOS) in the anlotinib group. In PSA, the probability of anlotinib being cost-effective was 26.6% and 78.5% when the WTP threshold was one and three times the GDP per capita, respectively. Conclusion Anlotinib is likely to be a cost-effective option compared with placebo for patients with relapsed SCLC who experience failure of at least two lines of chemotherapy in China. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01889-2.

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Section: Discussionmentioning

confidence: 99%