Cost-effectiveness analysis of pembrolizumab vs. chemotherapy as second-line treatment for advanced esophageal carcinoma in the United States

• DOI: 10.3389/fpubh.2022.941738
• Publication Date: 2022-12-09T04:51:01Z
• Authors: Jia Hu; Zhuomiao Ye; Zhe Xu; Zhinan Hao; Yongjun Wang
• Keywords: programmed death ligand-1; Lung Neoplasms; Esophageal Neoplasms; Cost-Benefit Analysis; Cost-Effectiveness Analysis; Carcinoma; United States; B7-H1 Antigen; esophageal squamous cell carcinoma; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Esophageal carcinoma; Carcinoma, Non-Small-Cell Lung; Humans; pembrolizumab; Public Health; Esophageal Squamous Cell Carcinoma; Public aspects of medicine; RA1-1270; cost-effectiveness

The national Comprehensive Cancer Network has suggested pembrolizumab as a second-line therapy for esophageal squamous cell carcinoma (ESCC) patients with programmed death ligand-1 (PD-L1) combined positive score (CPS) ≥ 10. However, despite the increased survival rate associated in these patient population, high cost of may influence its antitumor effect. This study aimed to evaluate cost-effectiveness compared chemotherapy treatments (EC) based on KEYNOTE-181 trial.A Markov model was constructed using TreeAge 2021 three different groups: all intent-to-treat (ITT population), ESCC (ESCC and PD-L1 CPS ≥10 (CPS population). Incremental cost, effect, Life-years, quality-adjusted life-years (QALYs) incremental ratio (ICER) were calculated. Analyses conducted setting willingness-to-pay threshold $150,000 from US perspective.The ICERs $157,589.545 per QALY, $60,238.823 $100,114.929 QALY ITT, ESCC, CPS≥10 populations, respectively. ICER ITT population higher than $150,000, suggesting that not cost-effective treatment scheme ≤ 10 or adenocarcinoma. < indicating two subgroups.The determining EC United States depends histologic type expression.