Cost-Utility Analysis of Pembrolizumab Combined with Gemcitabine and Cisplatin in the Treatment of Advanced Biliary Tract Cancer

Zhang H, Wang H, Long Y and Ge W

School of International Pharmaceutical Business, China Pharmaceutical University Nanjing Drum Tower Hospital, China
Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, China
School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University Nanjing Drum Tower Hospital, China
These authors contributed equally to this work

^*Correspondance to: Hao Wang 

 PDF  Full Text Research Article | Open Access

Abstract:

Background: The latest KEYNOTE-966 trial shows that compared with conventional chemotherapy, pembrolizumab treatment significantly improves the overall survival benefit of patients with advanced Biliary Tract Cancer (BTC). The purpose of this study was to compare the economics of pembrolizumab combined with chemotherapy as a first-line treatment for advanced BTC. Methods: A partition survival model was established to simulate the life-long survival benefit and cost consumption of patients. Obtain efficacy and safety data from the KEYNOTE-966 trial and local cost and resource use data from online databases and published studies. The results were expressed as total cost, incremental cost, life years, Quality-Adjusted Life Years (QALYs), incremental QALYs, and Incremental Cost-Effectiveness Ratio (ICER). The stability of the model was tested by singlefactor sensitivity and probability sensitivity analysis. Results: The results of basic analysis showed that compared with traditional chemotherapy, patients in the pembrolizumab group could obtain 0.295 QALYs more, cost $349,307.329 more, and the incremental cost-effectiveness ratio ICER was $1,182,369.991/QALY, which was much higher than the Willingness to Pay Threshold (WTP), that is, three times China's per capita gross domestic product in 2021 ($33,471.3). Single-factor sensitivity analysis showed that the price of pembrolizumab had a great influence on ICER value. The results of probability sensitivity analysis showed that when the WTP value was 3 times of 2021 GDP, the probability of pembrolizumab being economical was 0. Conclusion: When the WTP threshold is 3 times China's per capita GDP in 2021, the first-line treatment of advanced biliary tract cancer with a pembrolizumab regimen is not economical compared with traditional chemotherapy regimens.

Keywords:

Pembrolizumab; Gemcitabine; Biliary tract cancer; Cost-utility analysis; Chemotherapy

Cite the Article:

Zhang H, Wang H, Long Y, Ge W. Cost-Utility Analysis of Pembrolizumab Combined with Gemcitabine and Cisplatin in the Treatment of Advanced Biliary Tract Cancer. Clin Oncol. 2024;9:2045..