Cost-effectiveness analysis of pembrolizumab in first-line treatment of patients with unresectable or metastatic MSI-H/dMMR colorectal cancer

Cost-effectiveness analysis of pembrolizumab in first-line treatment of patients with unresectable or metastatic MSI-H/dMMR colorectal cancer

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Kai-xuan WANG^a^,^b^,^c, Shun-ping LI^a^,^b^,^c, Lei DOU^a^,^b^,^c, Shi-xian LIU^a^,^b^,^c, Zhao SHI^a^,^b^,^c, Rui-xue WANG^a^,^b^,^c, Xiao-hong ZHU^a^,^b^,^c, Ze-hua SONG^a^,^b^,^c

Chinese Journal of New Drugs and Clinical Remedies | 2024, 43(3) : 229 - 235

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Chinese Journal of New Drugs and Clinical Remedies | 2024, 43(3): 229-235

• Original Article •

Cost-effectiveness analysis of pembrolizumab in first-line treatment of patients with unresectable or metastatic MSI-H/dMMR colorectal cancer

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Kai-xuan WANG^a^,^b^,^c, Shun-ping LI^a^,^b^,^c, Lei DOU^a^,^b^,^c, Shi-xian LIU^a^,^b^,^c, Zhao SHI^a^,^b^,^c, Rui-xue WANG^a^,^b^,^c, Xiao-hong ZHU^a^,^b^,^c, Ze-hua SONG^a^,^b^,^c

Affiliations

^a.Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Ji-nan SHANDONG 250012, China

^b.NHC Key Lab of Health Economics and Policy Research, Shandong University, Ji-nan SHANDONG 250012, China

^c.Center for Health Preference Research, Shandong University, Ji-nan SHANDONG 250012, China

Published: 2024-03-25 doi: 10.14109/j.cnki.xyylc.2024.03.13

Outline

Abstract

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AIM

To evaluate the economics of pembrolizumab in the first-line treatment of patients with unresectable or metastatic microsatellite instability-high/mismatch repair-deficient （MSI-H/dMMR） colorectal cancer.

METHODS

Based on the Chinese healthcare system, a partitioned survival model was constructed to compare the cost and utility between pembrolizumab and standard of care using KEYNOTE-177 clinical trial data. The cycle length and time horizon of the model was set as 21 days and 10 years, respectively. The incremental cost-effectiveness ratio （ICER） was used as the evaluation indicator. Scenario analysis and sensitivity analysis were also performed.

RESULTS

Compared with standard of care, the ICER of pembrolizumab was 221 546.85 yuan·QALY^-1, which was lower than 3 times China’s per capita gross domestic product （GDP） in 2021. The pembrolizumab was dominant when patient assistance program was considered. The results of one-way sensitivity analysis showed that the proportion of pembrolizumab on subsequent treatment in the standard of care, pembrolizumab price and discounting exhibited the significant impact on the ICER. The results of probability sensitivity analysis showed that under the 3 times China’s per capita GDP in 2021, the probability of pembrolizumab being cost-effectiveness was 63.36%.

CONCLUSION

Pembrolizumab has a cost-effective advantage over standard of care as first-line treatment for unresectable or metastatic MSI-H/dMMR colorectal cancer in China.

Key words

pembrolizumab / colorectal neoplasms / microsatellite instability / cost-utility analysis / partitioned survival model

Cite this Article

Kai-xuan WANG, Shun-ping LI, Lei DOU, Shi-xian LIU, Zhao SHI, Rui-xue WANG, Xiao-hong ZHU, Ze-hua SONG. Cost-effectiveness analysis of pembrolizumab in first-line treatment of patients with unresectable or metastatic MSI-H/dMMR colorectal cancer[J]. Chinese Journal of New Drugs and Clinical Remedies, 2024 , 43 (3) : 229 -235 . DOI: 10.14109/j.cnki.xyylc.2024.03.13

Appendix

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Year 2024 volume 43 Issue 3

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Article Info

doi: 10.14109/j.cnki.xyylc.2024.03.13

Receive Date：2022-05-11
Online Date：2026-03-13
Published：2024-03-25

Article Data

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History

Received：2022-05-11
Accepted：2023-08-24

Affiliations

^a.Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Ji-nan SHANDONG 250012, China

^b.NHC Key Lab of Health Economics and Policy Research, Shandong University, Ji-nan SHANDONG 250012, China

^c.Center for Health Preference Research, Shandong University, Ji-nan SHANDONG 250012, China

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表12种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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