Cancer Management and Research (Nov 2019)

Cost-Effectiveness Analysis Of Pembrolizumab In The Treatment Of Advanced Recurrent Metastatic Head And Neck Squamous Cell Carcinoma In China And The United States

  • Liu M,
  • Han S,
  • Zheng B,
  • Cai H,
  • Yang J,
  • Zhuang Q,
  • Li N

Journal volume & issue
Vol. Volume 11
pp. 9483 – 9493

Abstract

Read online

Maobai Liu,1,2,* Sijie Han,2,* Bin Zheng,1,2 Hongfu Cai,1,2 Jing Yang,1,2 Qian Zhuang,1,2 Na Li1,2 1Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China; 2The School of Pharmacy, Fujian Medical University, Fuzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Na LiDepartment of Pharmacy, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, Fujian 350001, People’s Republic of ChinaEmail [email protected]: Pembrolizumab, a programmed cell death-1 (PD-1) inhibitor, has recently gained prominence as a second-line treatment for recurrent and/or metastatic head and neck squamous cell cancer (R/M HNSCC). This study compares the acceptance and different influencing factors of pembrolizumab in the treatment of R/M HNSCC in developed (i.e., the United States) and developing (i.e., China) countries through cost-effectiveness analysis and provides valuable suggestions for clinical decision making.Methods: A Markov model was constructed using TreeAge Pro 2015 software to evaluate the economic value of four treatment strategies. Quality-adjusted life years (QALY) and incremental cost-effectiveness ratio (ICER) were used as economic indicators for incremental cost-effectiveness analysis. The stability of the model was evaluated by one-way sensitivity and probability sensitivity analyses.Results: The ICERs for the pembrolizumab group versus PD-L1 CPS treatment in China and the US were $7892/QALY and $11,900/QALY, respectively. All ICERs were less than the threshold of $29,306 in China and $50,000 in the US; thus, pembrolizumab is cost effective. Sensitivity analysis confirmed a stable economic advantage in the single-drug regimen of pembrolizumab in China and the US.Conclusion: Pembrolizumab monotherapy as a second-line treatment for R/M HNSCC presents more health benefits in comparison with the standard, PD-L1 TPS and PD-L1 CPS groups in China and the US.Keywords: pembrolizumab, head and neck cancer, cost-effectiveness

Keywords