ArticleBMJ open2026
Value-based pricing of tislelizumab plus chemotherapy versus chemotherapy alone for advanced oesophageal squamous cell carcinoma: a Markov modelling study from the US payer perspective.
Article in BMJ open, 2026. 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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5 authors.
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Abstract
objectiveThis study aimed to determine the value-based price range at which tislelizumab combined with chemotherapy becomes cost-effective compared with chemotherapy alone for treating advanced oesophageal squamous cell carcinoma.
designWe constructed a three-state Markov model over a lifetime horizon, following the same protocols in the RATIONALE-306 trial. One-way and probabilistic sensitivity analyses were performed to assess model robustness. SETTINGS: US healthcare system, payer perspective. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome of the model included value-based per-cycle price of tislelizumab at willingness-to-pay thresholds from US$50 000 to US$200 000 per quality-adjusted life-year (QALY). Secondary outcomes were life years and QALY over life-time horizon.
interventionsTislelizumab+chemotherapy versus chemotherapy alone followed by second-line paclitaxel in both arms.
resultsTislelizumab resulted in a gain of 0.543 QALYs (95% CI 0.432 to 0.610) and 0.837 life-years (95% CI 0.780 to 0.915) compared with chemotherapy alone. The value-based price of tislelizumab was determined to be US$1575 to US$7160 per cycle when the willingness to pay threshold was set at US$50 000-US$200 000 per QALY. Sensitivity analyses confirmed the model's robustness at these price points across various model parameters.
conclusionsThis study established a value-based price range for tislelizumab in oesophageal squamous cell carcinoma treatment using robust economic modelling. These findings can be used to guide payers in coverage decisions and inform pricing negotiations for emerging immunotherapies.
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