Abstract
OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of toripalimab plus chemotherapy compared to chemotherapy alone as first-line therapy for extensive-stage small cell lung cancer(ES-SCLC) from the Chinese medical perspective. METHODS: Our study utilized a partitioned survival model to estimate the costs and clinical outcomes for patients with ES-SCLC. The model incorporated direct healthcare costs and clinical outcomes.The primary outcome measures used in our analysis were quality adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER). These measures were employed to evaluate the cost-effectiveness advantage of the treatment strategy by comparing it to the willingness-to-pay (WTP) thresholds. To account for uncertainties in the model results, One-way and probabilistic sensitivity analyses were conducted to assess the uncertainty of the model results. RESULTS: The base-case analysis showed that the total cost for toripalimab plus chemotherapy was $50,918.81, while the cost for chemotherapy was $20,280.31.The combination toripalimab therapy led to a higher QALY value of 1.59 compared to 0.55 for chemotherapy. This translated into an ICER of $29,460.09 per QALY gained, which was below the WTP threshold of $40,343.68 per QALY. The results of the sensitivity analyses demonstrated that the findings were not significantly affected by changes in any of the input parameters. CONCLUSION: Our analysis suggests that toripalimab plus chemotherapy is likely to be a cost-effective first-line therapy for ES-SCLC compared to chemotherapy alone, based on the WTP threshold of $40343.68 per QALY.