Abstract
OBJECTIVES: Penpulimab is a novel programmed death-1 (PD-1) inhibitor that has been approved in China for use in combination with chemotherapy as a first-line treatment for locally advanced or metastatic squamous non-small cell lung cancer (sq-NSCLC). However, the cost-effectiveness of this treatment in China remains to be determined. In this study, we aimed to assess the cost-effectiveness of penpulimab combined with paclitaxel and carboplatin for metastatic sq-NSCLC. DESIGN: Based on the AK105-302 trial (NCT03866993), a Markov model was created to evaluate the disease progression of metastatic sq-NSCLC patients over 10 years. The model included progression-free survival, progressive disease and death. The utility values were derived from published literature. Sensitivity studies were used to assess the robustness of the model outputs. SETTING: The Chinese healthcare system perspective. PARTICIPANTS: A hypothetical Chinese cohort of patients with locally advanced or metastatic sq-NSCLC. INTERVENTIONS: Penpulimab plus chemotherapy versus chemotherapy. PRIMARY OUTCOME MEASURE: Costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER). RESULTS: Compared with the chemotherapy alone group, the cost of penpulimab plus chemotherapy increased by US$3717.72, with an increase of 0.43 QALYs. The ICER was US$8625.78/QALY, which was well below the willingness-to-pay threshold of US$38 052/QALY. This demonstrated higher cost-effectiveness benefits, as confirmed by the sensitivity analysis results. CONCLUSIONS: Under the Chinese health system, penpulimab plus paclitaxel and carboplatin is cost-effective for metastatic sq-NSCLC patients and can be used as an economical and effective treatment option.