ArticleCancer medicine2023
Cost-effectiveness of first-line immunotherapies for advanced non-small cell lung cancer.
Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Adverse Event Costs and Cost-Effectiveness Analyses of Anticancer Drugs: A Systematic Review.JAMA network open · 2025Pooled it
- Barriers to Immune Checkpoint Inhibitor Access for Patients With Cancer in Southeast Asia: Challenges and Policy Implications.JCO global oncology · 2025Article
- Cost-Effectiveness of Pembrolizumab Monotherapy for High Programmed Death Ligand 1 Advanced or Metastatic Non-small Cell Lung Cancer Depends on Long-Term Survivors.Clinical drug investigation · 2025Article
- Economic Evaluation of Penpulimab Plus Paclitaxel and Carboplatin Combination Therapy as First-Line Treatment for Locally Advanced or Metastatic Squamous Non-small Cell Lung Cancer in China.Clinical drug investigation · 2025Article
- Cost-effectiveness of cemiplimab plus chemotherapy vs pembrolizumab plus chemotherapy as first-line treatment for advanced non-small cell lung cancer.Journal of managed care & specialty pharmacy · 2025Article
- Real-world clinical and economic outcomes for patients with advanced non-small cell lung cancer enrolled in a clinical trial following comprehensive genomic profiling via liquid biopsy.Journal of managed care & specialty pharmacy · 2024Article
- Estimating Costs Associated with Adverse Events in Patients with Advanced Lung Cancer.ClinicoEconomics and outcomes research : CEOR · 2024Article
- First-line treatments for advanced non-squamous non-small cell lung cancer with immune checkpoint inhibitors plus chemotherapy: a systematic review, network meta-analysis, and cost-effectiveness analysis.Therapeutic advances in medical oncology · 2024Article
- Cost-effectiveness of first-line immunotherapies for advanced non-small cell lung cancer.Cancer medicine · 2023Article
- Research advances in mechanism of antiangiogenic therapy combined with immune checkpoint inhibitors for treatment of non-small cell lung cancer.Frontiers in immunology · 2023Review
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundResearchers have not simultaneously compared the cost-effectiveness of six immunotherapies with chemotherapy for advanced non-small cell lung cancer. This study evaluated the cost-effectiveness across different programmed death-ligand 1 (PD-L1) levels.
methodsA Markov model with lifetime horizon was created for seven regimens: pembrolizumab plus chemotherapy (pembro-chemo), nivolumab plus ipilimumab (nivo-ipi), nivolumab, ipilimumab plus chemotherapy (nivo-ipi-chemo), atezolizumab plus chemotherapy (atezo-chemo), atezolizumab, bevacizumab plus chemotherapy (atezo-beva-chemo), single-agent pembrolizumab, and chemotherapy alone. Input parameters were derived from trial data, a network meta-analysis, and other literature. We conducted the analysis from the perspective of US health care sector.
resultsFor all patients without considering PD-L1 expression, the incremental cost-effectiveness ratio (ICER) of pembro-chemo versus chemotherapy was $183,299 per quality-adjusted life year (QALY). The preferred regimens based on ICERs differed by PD-L1 levels. For patients with PD-L1 ≥50%, pembrolizumab versus chemotherapy and pembro-chemo versus pembrolizumab resulted in ICERs of $96,189 and $198,913 per QALY, respectively. The other strategies were dominated. For patients with PD-L1 of 1%-49%, the ICER of pembro-chemo comparing to chemotherapy was $218,159 per QALY. The other regimens were dominated by pembro-chemo. For patients with PD-L1 <1%, nivo-ipi versus chemotherapy and nivo-ipi-chemo versus nivo-ipi resulted in ICERs of $161,277 and $881,975 per QALY, and the other regimens were dominated strategies. At the willingness-to-pay threshold of $150,000 per QALY, pembrolizumab had 87% and pembro-chemo had 1% probabilities being cost-effective in patients with PD-L1 ≥50% and 1%-49%, respectively. Nivo-ipi had a 34% probability being cost-effective in patients with PD-L1 <1%.
conclusionsThe PD-L1 level should be incorporated into treatment decision-making. Our findings suggest that first-line pembrolizumab, pembro-chemo, and nivo-ipi are the preferred strategies for patients with PD-L1 ≥50%, 1%-49%, and <1%, respectively.
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