Cost-effectiveness analysis of dostarlimab plus carboplatin-paclitaxel as first-line treatment for advanced endometrial cancer
BackgroundA recent phase III clinical trial (NCT03981796) evaluated the efficacy and safety of dostarlimab combined with carboplatin-paclitaxel (DOS-CP) compared to placebo combined with carboplatin-paclitaxel (PLB-CP) as a first-line treatment for advanced endometrial cancer (EC). The NCT03981796 t...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1267322/full |
| _version_ | 1797693170537988096 |
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| author | Maojin You Xiaoling Zeng Jinrong Zhang Yufan Huang Yalan Zhang Zhongjie Cai Yingying Hu |
| author_facet | Maojin You Xiaoling Zeng Jinrong Zhang Yufan Huang Yalan Zhang Zhongjie Cai Yingying Hu |
| author_sort | Maojin You |
| collection | DOAJ |
| description | BackgroundA recent phase III clinical trial (NCT03981796) evaluated the efficacy and safety of dostarlimab combined with carboplatin-paclitaxel (DOS-CP) compared to placebo combined with carboplatin-paclitaxel (PLB-CP) as a first-line treatment for advanced endometrial cancer (EC). The NCT03981796 trial demonstrated that DOS-CP significantly improved progression-free survival and overall survival of patients with advanced EC while maintaining an acceptable safety profile. However, DOS-CP is expensive and its cost-effectiveness has not been evaluated. This study aims to evaluate the cost-effectiveness of DOS-CP compared to PLB-CP as a first-line treatment for advanced EC from the perspective of the Chinese healthcare system.MethodsA Markov model with three health states was developed to evaluate the cost-effectiveness of DOS-CP as a first-line treatment for advanced EC. Clinical efficacy data were derived from the NCT03981796 trial, and drug costs were determined based on national tender prices. Other costs and utility values were obtained from published literature. The outcomes assessed included total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). The robustness of the model was assessed through one-way sensitivity analysis and probabilistic sensitivity analysis.ResultsIn comparison to PLB-CP, the ICER of DOS-CP was $98,276.61/QALY for the overall population, $53,063.61/QALY for the dMMR subgroup, and $124,088.56/QALY for the pMMR subgroup. All of these ICER values were higher than the willingness-to-pay threshold of $38,201 per QALY. The most important variable that affected the results of the model was the discount rate, the cost of dostarlimab, and the utility value for progressive disease.ConclusionFrom the perspective of the Chinese healthcare system, DOS-CP is unlikely to be a cost-effective first-line treatment option for advanced EC. |
| first_indexed | 2024-03-12T02:39:40Z |
| format | Article |
| id | doaj.art-cae46c1e22b6408a8a47eef3b9142e60 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-03-12T02:39:40Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-cae46c1e22b6408a8a47eef3b9142e602023-09-04T08:58:50ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-09-011410.3389/fimmu.2023.12673221267322Cost-effectiveness analysis of dostarlimab plus carboplatin-paclitaxel as first-line treatment for advanced endometrial cancerMaojin You0Xiaoling Zeng1Jinrong Zhang2Yufan Huang3Yalan Zhang4Zhongjie Cai5Yingying Hu6Department of Pharmacy, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, ChinaDepartment of Pharmacy, The Second Hospital of Zhangzhou, Zhangzhou, Fujian, ChinaDepartment of Pharmacy, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, ChinaDepartment of Pharmacy, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, ChinaDepartment of Pharmacy, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, ChinaDepartment of Pharmacy, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, ChinaDepartment of Pharmacy, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, ChinaBackgroundA recent phase III clinical trial (NCT03981796) evaluated the efficacy and safety of dostarlimab combined with carboplatin-paclitaxel (DOS-CP) compared to placebo combined with carboplatin-paclitaxel (PLB-CP) as a first-line treatment for advanced endometrial cancer (EC). The NCT03981796 trial demonstrated that DOS-CP significantly improved progression-free survival and overall survival of patients with advanced EC while maintaining an acceptable safety profile. However, DOS-CP is expensive and its cost-effectiveness has not been evaluated. This study aims to evaluate the cost-effectiveness of DOS-CP compared to PLB-CP as a first-line treatment for advanced EC from the perspective of the Chinese healthcare system.MethodsA Markov model with three health states was developed to evaluate the cost-effectiveness of DOS-CP as a first-line treatment for advanced EC. Clinical efficacy data were derived from the NCT03981796 trial, and drug costs were determined based on national tender prices. Other costs and utility values were obtained from published literature. The outcomes assessed included total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). The robustness of the model was assessed through one-way sensitivity analysis and probabilistic sensitivity analysis.ResultsIn comparison to PLB-CP, the ICER of DOS-CP was $98,276.61/QALY for the overall population, $53,063.61/QALY for the dMMR subgroup, and $124,088.56/QALY for the pMMR subgroup. All of these ICER values were higher than the willingness-to-pay threshold of $38,201 per QALY. The most important variable that affected the results of the model was the discount rate, the cost of dostarlimab, and the utility value for progressive disease.ConclusionFrom the perspective of the Chinese healthcare system, DOS-CP is unlikely to be a cost-effective first-line treatment option for advanced EC.https://www.frontiersin.org/articles/10.3389/fimmu.2023.1267322/fulldostarlimabcarboplatin-paclitaxelcost-effectivenessfirst-line treatmentendometrial cancer |
| spellingShingle | Maojin You Xiaoling Zeng Jinrong Zhang Yufan Huang Yalan Zhang Zhongjie Cai Yingying Hu Cost-effectiveness analysis of dostarlimab plus carboplatin-paclitaxel as first-line treatment for advanced endometrial cancer Frontiers in Immunology dostarlimab carboplatin-paclitaxel cost-effectiveness first-line treatment endometrial cancer |
| title | Cost-effectiveness analysis of dostarlimab plus carboplatin-paclitaxel as first-line treatment for advanced endometrial cancer |
| title_full | Cost-effectiveness analysis of dostarlimab plus carboplatin-paclitaxel as first-line treatment for advanced endometrial cancer |
| title_fullStr | Cost-effectiveness analysis of dostarlimab plus carboplatin-paclitaxel as first-line treatment for advanced endometrial cancer |
| title_full_unstemmed | Cost-effectiveness analysis of dostarlimab plus carboplatin-paclitaxel as first-line treatment for advanced endometrial cancer |
| title_short | Cost-effectiveness analysis of dostarlimab plus carboplatin-paclitaxel as first-line treatment for advanced endometrial cancer |
| title_sort | cost effectiveness analysis of dostarlimab plus carboplatin paclitaxel as first line treatment for advanced endometrial cancer |
| topic | dostarlimab carboplatin-paclitaxel cost-effectiveness first-line treatment endometrial cancer |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1267322/full |
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