Evidence map›Paper›PMID 41152654›Full record

ArticleJournal of cancer research and clinical oncology2025

Cost-effectiveness analysis of pembrolizumab versus chemotherapy in advanced non-small cell lung cancer in China based on real-world studies.

Ning Wan, Chen Yang, Bing Wang, Ya Guo, ZiJian He, YaJuan Lv, LiQing Lu, Ning Yang, WeiBin Xiao, YongBang Chen and 6 more

Abstract readComparative Study
In one paragraph

Article in Journal of cancer research and clinical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. Article
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

16 authors.

Ning Wan *Department of Clinical Pharmacy, General Hospital of Southern Theater Command, Guangzhou, 510010, China.
Chen Yang *Department of Clinical Pharmacy, General Hospital of Southern Theater Command, Guangzhou, 510010, China.
Bing Wang *Department of Pharmacy, Heyou Hospital, Shunde District, Foshan, 528306, China.
Ya GuoDepartment of Clinical Pharmacy, General Hospital of Southern Theater Command, Guangzhou, 510010, China.
ZiJian HeCollege of Pharmacy, Jinan University, Guangzhou, 510623, China.
YaJuan LvDepartment of Clinical Pharmacy, General Hospital of Southern Theater Command, Guangzhou, 510010, China.
LiQing LuDepartment of Clinical Pharmacy, General Hospital of Southern Theater Command, Guangzhou, 510010, China.
Ning YangDepartment of Oncology, General Hospital of Southern Theater Command, Guangzhou, 510010, China.
WeiBin XiaoDepartment of Clinical Pharmacy, General Hospital of Southern Theater Command, Guangzhou, 510010, China.
YongBang ChenDepartment of Pharmacy, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China.
Jin YuanDepartment of Clinical Pharmacy, General Hospital of Southern Theater Command, Guangzhou, 510010, China.
DanDan YangSchool of Pharmaceutical Science, Sun Yat-sen University, Guangzhou, 510006, China.
Tao LiuDepartment of Pharmacy, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.
WenFeng FangDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China. fangwf@sysucc.org.cn.
ZhuoJia ChenDepartment of Pharmacy, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China. chenzhj@sysucc.org.cn.
WeiTing LiangDepartment of Pharmacy, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China. liangwt@sysucc.org.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough pembrolizumab has been shown to be effective, its high price has prevented it from being widely used. Especially in the real world, the application situation is still uncertain. The purpose of this study was to evaluate the cost-effectiveness of pembrolizumab on the basis of real-world studies, from the perspective of the health care system.

methodsRetrospectively, 630 patients with advanced NSCLC treated with pembrolizumab (monotherapy or combination chemotherapy) versus chemotherapy alone from January 2020 to December 2022 at a large 3 A hospital in China were included. Confounders between groups were eliminated using propensity score matching analysis. A partitioned survival model was developed to evaluate the cost-effectiveness of pembrolizumab versus chemotherapy for the treatment of advanced NSCLC based on progression-free survival, overall survival, and the incidence of adverse effects in the two matched groups (n = 450 patients). The incremental cost-effectiveness ratio was calculated. The impact of a drug donation program on the cost-effectiveness of pembrolizumab was also evaluated.

resultsPembrolizumab significantly improved median PFS in patients (15.5 months vs. 8.8 months). The median OS in the Pembrolizumab group has not been reached, while it was 26.2 months in the chemotherapy group. When the drug donation program is not considered, the ICER of pembrolizumab is $146,409.07/QALY. Regardless of whether the willingness-to-pay threshold is set at three times the per capita GDP of China ($36,070.2) or three times the per capita GDP of Guangdong Province ($64,523.8), the use of pembrolizumab is not cost-effective. However, after considering the drug donation program, the ICER decreased to $56,127.74/QALY. Under the willingness-to-pay threshold of three times the per capita GDP of Guangzhou in 2022 ($64,523.8), pembrolizumab became a cost-effective choice.

conclusionIn the treatment of advanced NSCLC in China, pembrolizumab, particularly when considering the drug donation program, offers better survival outcomes and becomes cost-effective. This highlights the importance of such programs in making high-cost treatments accessible in real-world clinical settings.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Non-Small-Cell LungLung NeoplasmsAdultAgedChinaCost-Benefit AnalysisCost-Effectiveness AnalysisFemaleHumansMaleMiddle AgedRetrospective StudiesAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalpembrolizumabCost-effectiveness analysisNon-small cell lung cancerPartition survival modelPembrolizumabReal-world studies

Identifiers

PMID41152654
PMCPMC12569207

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.