ArticleJournal of managed care & specialty pharmacy2025
Cost-effectiveness of cemiplimab plus chemotherapy vs pembrolizumab plus chemotherapy as first-line treatment for advanced non-small cell lung cancer.
Article in Journal of managed care & specialty pharmacy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2022, the US Food and Drug Administration approved cemiplimab in combination with chemotherapy (CCT) as a first-line treatment for advanced non-small cell lung cancer (aNSCLC). However, whether CCT presents a cost-effective alternative to the previously preferred first-line treatment, pembrolizumab plus chemotherapy (PCT), remains uncertain.
objectiveTo evaluate the cost-effectiveness of CCT vs PCT as the first-line treatment for aNSCLC from a US health care payer perspective.
methodsA 3-state partitioned survival model with a 10-year horizon was constructed. Clinical data were derived from the EMPOWER-Lung 3, KEYNOTE-407, and KEYNOTE-189 trials. Costs and quality of life were obtained from published 2024 US list prices and literature. The cost, quality-adjusted life-years (QALYs) gained, and incremental cost-effectiveness ratio (ICER) were calculated. All outcomes were discounted at a rate of 3% per year. Scenario analyses, deterministic and probabilistic sensitivity analyses, and subgroup analyses were performed for patients with different programmed death ligand 1 (PD-L1) levels.
resultsIn the base-case analysis, the total cost of PCT was $207,926 with 1.609 QALYs, whereas CCT had a total cost of $175,247 with 1.657 QALYs. Results from the scenario analyses were consistent with the base-case analysis, indicating that CCT was a dominant treatment strategy over PCT (ICER =-$675,304 per QALY). The cost of pembrolizumab highly impacted the ICER. At a willingness-to-pay threshold of $150,000 per QALY, CCT would be accepted as a cost-effective option 96.9% of the time. In subgroup analyses, CCT remained a dominant alternative to PCT for patients with PD-L1 levels of at least 50% and 1%-49%.
conclusionsThis cost-effectiveness analysis suggests that CCT is a dominant first-line treatment option for aNSCLC with PD-L1 levels of at least 1% compared with PCT.
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