Economic evaluation of sintilimab versus docetaxel as second-line treatment for patients with advanced or metastatic squamous non-small-cell lung cancer in China: a model-based cost-effectiveness analysis

ABSTRACTObjectives The current study aimed to evaluate the cost-effectiveness of sintilimab versus docetaxel as second-line treatment for patients with advanced or metastatic squamous non-small-cell lung cancer (NSCLC) in China.Methods A partitioned survival model was established to track 3-week patients' transition and project the health and economic outputs in 15-year horizon of the two competing options among sintilimab and docetaxel. Clinical data were obtained from the ORIENT-3 trial, and cost and utility values were gathered from the local charges and published studies. Total costs, life-years, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) were evaluated. Sensitivity analyses were conducted to assess the robustness of the model outcomes.Results Base-case results revealed that sintilimab yield marginal cost of $4,700.53 and additional 0.32 QALYs, resulting in an ICER of $14,615.31 per QALY gained, which is lower than the willingness-to-pay threshold of $38,224/QALY in China. One-way sensitivity analyses showed that the cost of best supportive care was the main driver of the ICER, and probabilistic sensitivity analyses demonstrated that the model outputs were robust.Conclusions Sintilimab could be considered the cost-effective second-line strategy for patients with advanced or metastatic squamous NSCLC compared with docetaxel in China.KEYWORDS: Sintilimabdocetaxeladvanced or metastatic squamous non-small-cell lung cancercost-effectivenesssecond-line treatment Article highlights The ORIENT-3 trial motivated great interest for health-care decision-makers after the reports of the clinical benefit and safety profile from sintilimab for patients with advanced or metastatic squamous NSCLC.The aim of the current analysis was to assess the cost-effectiveness of sintilimab versus docetaxel as second-line treatment for patients with advanced or metastatic squamous NSCLC from Chinese health-care system perspective.Sintilimab yields additional 0.32 QALYs with marginal cost of $4,700.53, resulting in an ICER of $14615.31/QALY, which was lower than WTP threshold of $38,224/QALY in China.Sintilimab was likely to be the cost-effective second-line option for patients with advanced or metastatic squamous NSCLC due to the favorable ICER.Declaration of interestThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.Author contributionsM C Liao and S Kang were involved in the design of the study. M C Liao and S Kang collected the data and performed the economic analysis. M C Liao and S Kang drafted and critically revised the manuscript. Both authors contributed to the article and approved the submitted version.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Supplementary materialSupplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2267177.Additional informationFundingThis paper was not funded.