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. 2025 Jul 12;15(1):60.
doi: 10.1186/s13561-025-00656-1.

Cost-effectiveness analysis of penpulimab plus carboplatin-paclitaxel as first-line treatment for metastatic squamous non-small-cell lung cancer in China

Luwei Wang #  1 , Jiasheng Chen #  2 , Lihui Lin  3 , Xiaowei Huang  4
Affiliations

Cost-effectiveness analysis of penpulimab plus carboplatin-paclitaxel as first-line treatment for metastatic squamous non-small-cell lung cancer in China

Luwei Wang et al. Health Econ Rev. .

Abstract

Purpose: Squamous NSCLC (sqNSCLC), a subtype with few targetable mutations, is often diagnosed at advanced stages. Platinum-based chemo-therapy, the first-line treatment, yields median overall survival (OS) of less than or equal to one year, underscoring the need for better therapies. Penpulimab, a novel PD-1 inhibitor developed in China, is a humanized IgG1 antibody with a modified Fc region. Phase III trial data (AK105-302) showed penpulimab + carboplatin-paclitaxel (PEN-CP) significantly improved progression-free survival (PFS) and OS in metastatic sqNSCLC vs. placebo (CP), with a favorable safety profile. However, its high cost and lack of cost-effectiveness analyses warrant further study. This research evaluates PEN-CP's cost-effectiveness vs. CP from the Chinese healthcare perspective.

Methods: A three-state Markov model was developed to evaluate the cost-effectiveness of PEN-CP as a first-line treatment for metastatic sqNSCLC. Clinical efficacy data were sourced from the AK105-302 trial, while drug costs were derived from national tender prices. Additional costs and health utilities were obtained from published literature. The primary outcomes included total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). To assess the robustness of the findings, both one-way and probabilistic sensitivity analyses were conducted.

Results: Compared to CP, the ICER for PEN-CP was $14,918.81 per QALY. The ICER values were below the willingness-to-pay (WTP) threshold of $38,060.00 per QALY. The key drivers of the model outcomes were the price of penpulimab, the PFS stage utility value, and the cost of optimal supportive care.

Conclusions: From the perspective of the Chinese healthcare system, penpulimab combined with first-line chemotherapy demonstrates is cost-effective at a willingness-to-pay threshold of $38,060.00 per QALY for patients with metastatic sqNSCLC and represents a promising first-line treatment option.

Keywords: Carboplatin-paclitaxel; Cost-effectiveness; First-line treatment; Metastatic SqNSCLC; Penpulimab.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The Markov model simulating outcomes for the AK105-302 trial. All patients started with PFS state and received treatment with PEN-CP or CP. PEN-CP penpulimab plus carboplatin-paclitaxel, sqNSCLC: squamous non-small-cell lung cancer; PD: progressive disease; PFS: progression-free survival; CP: placebo plus carboplatin-paclitaxel
Fig. 2
Fig. 2
One-way sensitivity analyses of PEN-CP in comparison with CP. PEN-CP: penpulimab plus carboplatin-paclitaxel; PFS: progression-free survival; PD: progressive disease; CP: placebo plus carboplatin-paclitaxel
Fig. 3
Fig. 3
A probabilistic scatter plot of the ICER between the PEN-CP group and the CP group. Each point means the ICER for 1 simulation. Ellipses are used to indicate 95% confidence intervals. Points that lie below the ICER threshold represent cost-effective simulations. PEN-CP: penpulimab plus carboplatin-paclitaxel; CP: placebo plus carboplatin-paclitaxel; QALYs: quality-adjusted life years; ICER: incremental cost-effectiveness ratio; WTP: willingness-to-pay
Fig. 4
Fig. 4
The cost-effectiveness acceptability curves in the overall population. PEN-CP: penpulimab plus carboplatin-paclitaxel; CP: placebo plus carboplatin-paclitaxel
See this image and copyright information in PMC

References

    1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer statistics 2020: GLOBOCAN esti-mates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49. - PubMed
    1. Novello S, Barlesi F, Califano R, et al. Metastatic non-small-cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment, and follow-up. Ann On-col. 2016;27(suppl 5):v1–27. - PubMed
    1. Ettinger DS, Wood DE, Aisner DL, et al. Non-small cell lung cancer, version 3.2022: NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2022;20(5):497–530. - PubMed
    1. Socinski MA, Obasaju C, Gandara D, et al. Current and emergent therapy options for advanced squamous cell lung cancer. J Thorac Oncol. 2018;13(2):165–83. - PubMed
    1. Wu Z, Zhang X, Li Y, et al. Sex disparity of lung cancer risk in non-smokers: a multi-center population-based prospective study based on China National lung Cancer screening program. Chin Med J (Engl). 2022;135(11):1331–9. - PMC - PubMed

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