Economic evaluation of toripalimab plus chemotherapy compared with chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma in China

Expert Rev Pharmacoecon Outcomes Res. 2023 Jul-Dec;23(6):683-690. doi: 10.1080/14737167.2023.2206570. Epub 2023 Apr 24.

Abstract

Objectives: The purpose of this study was to compare the cost-effectiveness of toripalimab versus Chemotherapy for patients with advanced esophageal squamous cell carcinoma (ESCC) from the perspective of the Chinese healthcare system.

Methods: A partitioned survival model was designed. Clinical data on survival was taken from the JUPITER-06 trials. Direct medical expenditures and utilities were gathered from published literature and a local database. One-way and probability sensitivity methods were used to evaluate the model's robustness.

Results: Compared with chemotherapy alone, toripalimab offered an incremental cost of $8950.427 with an additional 0.294 QALYs, yielding an ICER of 30,443.629$/QALYs first-line therapy for advanced ESCC. The ICER was below the threshold of willingness to pay in China, indicating that the toripalimab group had a cost-effective advantage. Sensitivity analysis showed that the ICERs were most sensitive to the utility of PD, but all the parameters had no significant impact on the model's outcomes.

Conclusion: Toripalimab may be a cost-effective first-line treatment choice in our research when compared to chemotherapy alone for patients with advanced ESCC.

Keywords: Chemotherapy; Cost-effectiveness; Esophageal squamous cell carcinoma; Recurrent or metastatic; Toripalimab.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Cost-Benefit Analysis
  • Esophageal Neoplasms* / drug therapy
  • Esophageal Squamous Cell Carcinoma* / drug therapy
  • Humans
  • Markov Chains

Substances

  • toripalimab