Cost-effectiveness Analysis of Durvalumab Plus Chemotherapy for Extensive-stage Small-Cell Lung Cancer

OBJECTIVE  To analyze the cost-effectiveness of the durvalumab plus chemotherapy regimen for extensive-stage small-cell lung cancer(ES-SCLC) from the perspective of the Chinese healthcare system.

METHODS A partitioned survival model was constructed using survival data from the CASPIAN study and incorporating direct medical costs. The incremental cost-effectiveness ratio(ICER) served as the primary outcome measure, with the cost-effectiveness of the durvalumab combination regimen determined through comparison of the ICER value against established willingness-to-pay thresholds. Sensitivity and scenario analyses were performed to test the robustness of the conclusions.

RESULTS  The ICER for the durvalumab plus chemotherapy regimen compared to chemotherapy alone was 2 695 436 yuan·(quality-adjusted life-years)⁻¹. The progressive disease and progression-free survival phases, along with the cost of durvalumab, had the greatest impact on the ICER. Both sensitivity and scenario analyses demonstrated the stability of the conclusions across various parameters.

CONCLUSION Durvalumab in combination with chemotherapy is not cost-effective for ES-SCLC treatment under the current economic level in China.