Evidence map›Paper›PMID 31250401›Full record

ArticleClinical drug investigation2019

Cost-effectiveness Analysis of Pembrolizumab Plus Axitinib Versus Sunitinib in First-line Advanced Renal Cell Carcinoma in China.

Jun Chen, Gaoyun Hu, Zhuo Chen, Xiaomin Wan, Chongqing Tan, Xiaohui Zeng, Zeneng Cheng

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Clinical drug investigation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jun ChenXiangya School of Pharmacy, Central South University, Changsha, 410013, Hunan, China.
Gaoyun HuXiangya School of Pharmacy, Central South University, Changsha, 410013, Hunan, China.
Zhuo ChenXiangya School of Pharmacy, Central South University, Changsha, 410013, Hunan, China.
Xiaomin WanDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Chongqing TanDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Xiaohui ZengPET-CT Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Zeneng ChengXiangya School of Pharmacy, Central South University, Changsha, 410013, Hunan, China. chengzeneng2019@163.com.

Funding

National Natural Science Foundation of China 81603081Natural Science Foundation of Chongqing (CN) 81401547
6 · The paper itself

Abstract

BACKGROUND AND

objectivesIn first-line treatment of advanced renal cell carcinoma (aRCC), the KEYNOTE-426 study demonstrated a significant progression-free survival and overall survival for pembrolizumab plus axitinib in comparison with sunitinib. The objective of the current study was to evaluate the cost effectiveness of pembrolizumab plus axitinib versus sunitinib for previously untreated patients with aRCC in China.

methodsA Markov model was used to estimate the costs and health outcomes of treatment of aRCC with sunitinib or pembrolizumab plus axitinib. Univariable and probabilistic sensitivity analyses were performed to determine the robustness of the model outcomes. Additional subgroup analyses were also performed. The primary outputs of the model included the total cost, life-years (LYs), quality-adjusted LYs (QALYs), and incremental cost-effectiveness ratio (ICER).

resultsPembrolizumab plus axitinib provided an additional 2.461 LYs (1.650 QALYs). The total cost per patient was US$178,725 for pembrolizumab plus axitinib and US$87,693 for sunitinib. The ICER for pembrolizumab plus axitinib was US$55,185/QALY versus sunitinib. Sensitivity analyses found the results to be most sensitive to pembrolizumab cost and overall hazard ratio. The results of subgroup analyses showed that the ICER remained greater than US$32,000/QALY across the all patient subgroups.

conclusionsPembrolizumab plus axitinib is not likely to be cost effective versus sunitinib for patients with previously untreated aRCC at a threshold value of US$29,306/QALY.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalAxitinibCarcinoma, Renal CellChinaCost-Benefit AnalysisDrug Therapy, CombinationHumansKidney NeoplasmsQuality-Adjusted Life YearsSunitinibAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalAxitinibpembrolizumabSunitinib

Identifiers

PMID31250401

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.