Objectives: Durvalumab plus chemotherapy could significantly improve overall survival compared with chemotherapy alone in the first-line treatment of extensive-stage small-cell lung cancer (SCLC). However, its long-term economic outcomes remain unclear yet. This study aimed to evaluate the cost-effectiveness of adding durvalumab to first-line chemotherapy for extensive-stage SCLC from the perspective of the Chinese health-care system.
Methods: A decision-analytic model with 10-year horizon was developed to estimate the health and economic outcomes of adding durvalumab to first-line treatment for extensive-stage SCLC. The primary outcomes included total costs, life years (LYs), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). Costs and utility values were obtained from the published literature. A scenario analysis for a patient assistance program (PAP) was conducted. Sensitivity analyses were performed to explore the robustness of the model outcomes.
Results: Durvalumab plus chemotherapy yielded additional 0.25 QALYs, with incremental costs of 76,354 USD, resulting in an ICER of 302,051 USD/QALY compared with chemotherapy alone, when PAP was available, the ICER was 192,591 USD/QALY. Sensitivity analyses confirmed the robustness of model outcomes.
Conclusion: Adding durvalumab to first-line chemotherapy for extensive-stage small-cell lung cancer is unlikely to be cost-effectiveness in China.
Keywords: China; Durvalumab; chemotherapy; cost-effectiveness analysis; extensive-stage small-cell lung cancer; first-line treatment.