Abstract
OBJECTIVE: This study evaluates the cost-effectiveness of tislelizumab plus chemotherapy as a first-line treatment for locally advanced or metastatic (IIIB/IV) nonsquamous non-small cell lung cancer (nsq-NSCLC) in China. METHODS: A Markov model projected health outcomes and costs over a lifetime, with health states including progression-free survival, progressive disease, terminal progressive disease (TPD) and death. Data came from a Chinese phase III trial. The primary outcome was quality-adjusted life years (QALYs), with incremental cost-effectiveness ratios (ICERs) calculated. Using sensitivity analysis to confirm the robustness of the results. RESULTS: The base-case analysis showed that tislelizumab combined chemotherapy group had 1.06 more QALYs (3.967 QALYs VS 2.909 QALYs) than the chemotherapy-alone group at an incremental cost of U.S. dollars ($) 19594.75 ($43390.52 VS $23795.77), resulting in an ICER of $18,512.47/QALY. This ICER is below the willingness-to-pay (WTP) threshold of three times China's 2023 per capita GDP ($36,672.23/QALY), indicating tislelizumab is economically favorable. CONCLUSION: The conclusion is that tislelizumab combination therapy is a cost-effective first-line treatment option for nsq-NSCLC patients in China.