ArticleFrontiers in pharmacology2025
Cost-effectiveness analysis of toripalimab plus chemotherapy versus standard chemotherapy in first-line treatment for extensive-stage small cell lung cancer: perspectives from the United States and China.
Article in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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7 authors.
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Abstract
Background: Toripalimab combined with chemotherapy has demonstrated significant clinical advantages in improving overall survival compared with chemotherapy alone as a first-line treatment for extensive-stage small-cell lung cancer (ES-SCLC). Method: An economic evaluation was conducted using a Markov state-transition model to reflect the perspectives of the United States payer and Chinese healthcare systems. Primary outcomes included quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER), incremental net health benefit (INHB), and incremental net monetary benefit (INMB). Results: Base-case analysis indicated that incorporating toripalimab into chemotherapy produced an ICER of $45,629.27 per QALY, exceeding China's willingness-to-pay (WTP) threshold of $38,042.49 per QALY. Subgroup analyses revealed ICERs of $22,345.99 and $30,867.38 per QALY for patients with low intratumor heterogeneity (ITH-L) and A11+/B62- histology, respectively, both below the China WTP threshold. In contrast, in the United States, the additional cost led to unfavorable ICERs of $842,855.23, $328,694.61, and $520,412.03 per QALY for the overall population, the ITH-L subgroup, and the A11+/B62- subgroup, respectively, each exceeding the United States WTP threshold of $150,000.00. Conclusion: The combination of toripalimab and chemotherapy was not found to be a cost-effective first-line treatment for ES-SCLC in China or the United States, except for patients in China with ITH-L and A11+/B62- histology.
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