Cost?effectiveness of lobaplatin?etoposide versus cisplatin?etoposide as the first?line therapy for patients with extensive stage small cell lung cancer in China

CHEN Hao; CHENG Ying.

Abstract：investigate the cost?effectiveness of lobaplatin plus etoposide (EL) versus cisplatin plus etoposide (EP) regimen as the first?line therapy for extensive stage small cell lung cancer(ES?SCLC) from a healthcare payer's perspective in Chi?na. Methods A decision?analytic Markov model was developed to simulate the lifetime clinical and economic outcomes of ES?SCLC treatment. Clinical data were obtained from a phaseⅢrandomized clinical trial that compared EL versus EP regimen in patients with pre?viously untreated ES?SCLC. Cost data were obtained from literature and interview with a panel of clinical experts. Incremental cost?effec?tiveness ratio (ICER) was regarded as the primary outcome of the analysis.Sensitivity analyses were performed to explore the robust of es?sential variables on the results of the analysis. Results Treatment with EL regimen provided effectiveness gain of 0. 50 quality?adjusted life year (QALYs) at an average cost of 18 729 yuan, whereas EP regimen brought 0. 44 QALYs at the cost of 11 501 yuan.The ICER of EL regimen versus EP regimen was 127 206 yuan／QALY.In a probabilistic sensitivity analysis based on a Monte Carlo simulation of 1000 patients, the probabilities that EL regimen was a cost?effective choice over EP regimen were 0. 1%, 36. 5% and 98. 5% using a willing?ness?to?pay threshold of 1, or 2 or 3 times GDP per capita in China (64 644 yuan). Conclusion Treatment with EL regimen in ES?SCLC patients increased QALYs compared with EP regimen. The model demonstrates that EL regimen may be considered a cost?effective treatment compared with EP regimen as the first?line therapy in patients with ES?SCLC in China under 3 times GDP per capita.