Cost-effectiveness analysis of sintilimab additional to chemoradiotherapy in high-risk locoregionally advanced nasopharyngeal carcinoma

TL;DR

Adding sintilimab to standard therapy for advanced nasopharyngeal cancer improves quality of life but increases costs, making it a potentially cost-effective treatment.

Contribution

This study is the first to evaluate the cost-effectiveness of sintilimab in high-risk nasopharyngeal carcinoma using a Markov model and sensitivity analyses.

Findings

Sintilimab added to standard therapy provided 3.10 extra QALYs at an additional cost of $24,208.60.

The ICER was $7,819.67 per QALY, indicating cost-effectiveness.

The treatment had a 95.4% probability of being cost-effective.

Abstract

The recently released CONTINUUM trial was the first phase 3 randomized study to demonstrate the efficacy and safety of immunotherapy in high-risk locoregionally advanced nasopharyngeal carcinoma (NPC), showing that sintilimab can bring clinical benefits to these populations.

We developed a Markov model to assess the cost and effectiveness of sintilimab plus standard therapy versus standard therapy alone. The primary outcomes included total costs, life-years, quality adjusted life years (QALYs) and incremental cost-effective ratios (ICERs). A series of sensitivity analyses were conducted to test the stability of the model.

When compared to standard therapy, the addition of sintilimab yielded extra 3.10 QALYs at an increased cost of $24208.60, resulting in an ICER of $7819.669 per QALY. Our one-way sensitivity analysis indicated that the utility of event-free survival and the risk of leukopenia/neutropenia in immunotherapy group were the most influential factors impacting the results. The incorporation of sintilimab alongside standard therapy demonstrated a 95.4% probability of being cost-effective.

First-line induction-concurrent chemoradiotherapy with sintilimab was identified as a cost-effectiveness treatment option for high-risk locoregionally advanced NPC.

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