The base case results.

ObjectiveThis study aims to assess the cost-effectiveness of adebrelimab in combination with chemotherapy as a first-line treatment for extensive-stage small cell lung cancer (ES-SCLC) from the Chinese medical perspective.MethodsWe have designed a partitioned survival model. The model integrates clinical information pertaining to overall survival, progression-free survival, adverse events and cost data. Our primary measure of outcome in this model is quality-adjusted life years (QALY) and the incremental cost-effectiveness ratio (ICER). The model adopted a willingness to pay (WTP) threshold of $40,343.68 per QALY. To account for uncertainty in the model parameters, we conducted sensitivity analyses.ResultsThe total expenditure for the adebrelimab group was $79,549.34, compared to $6,436.80 for the chemotherapy group. The adebrelimab cohort achieved an incremental gain of 1.25 QALY, resulting in an additional cost of $73,112.54. Consequently, the ICER for the adebrelimab group was determined to be $58,490.03 per QALY, surpassing the WTP threshold of $40,343.68 in China. The sensitivity analyses demonstrated the robustness of the findings across various scenarios.ConclusionThis cost-effectiveness analysis indicates that adebrelimab plus chemotherapy as a first-line treatment for ES-SCLC was not cost-effective in China with a WTP of $40,343.68.Reducing the cost of adebrelimab promises to improve the cost-effectiveness of this treatment regimen.

研究目的：本研究旨在从中国医疗卫生视角，评估阿得贝利单抗联合化疗作为广泛期小细胞肺癌（extensive-stage small cell lung cancer, ES-SCLC）一线治疗方案的成本效益。研究方法：本研究构建了分区生存模型（partitioned survival model），该模型整合了总生存期、无进展生存期、不良事件及成本相关的临床数据。本模型的主要结局指标为质量调整生命年（quality-adjusted life years, QALY）与增量成本效果比（incremental cost-effectiveness ratio, ICER），并设定意愿支付（willingness to pay, WTP）阈值为每质量调整生命年40343.68美元。为考量模型参数的不确定性，本研究开展了敏感性分析。研究结果：阿得贝利单抗组的总治疗花费为79549.34美元，而单纯化疗组仅为6436.80美元；阿得贝利单抗队列的质量调整生命年增量为1.25年，额外产生的医疗成本为73112.54美元。据此计算，阿得贝利单抗组的增量成本效果比为每质量调整生命年58490.03美元，超过了中国40343.68美元的意愿支付阈值。敏感性分析结果证实，该研究结论在多种场景下均具有稳健性。研究结论：本成本效益分析表明，在意愿支付阈值为每质量调整生命年40343.68美元的标准下，阿得贝利单抗联合化疗作为广泛期小细胞肺癌一线治疗方案在我国并不具备成本效益。降低阿得贝利单抗的用药成本，有望提升该治疗方案的成本效益水平。