Objective Cemiplimab combined with chemotherapy has emerged as a promising treatment option for advanced non-small cell lung cancer (NSCLC). Accordingly, this study has been conducted to evaluate the cost-effectiveness of this combination therapy in comparison to chemotherapy alone from the perspective of the United States healthcare system. Methods The present study is based on a partitioned survival model developed from clinical data obtained during the 2-year follow-up of the phase III EMPOWER-Lung 3 part 2 trial. The purpose of this investigation is to estimate the 10-year life expectancy and total healthcare costs of patients with advanced NSCLC by leveraging primary outcomes that evaluated costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER).To establish the willingness-to-pay (WTP) threshold for the analysis, a value of $150,000/QALY was adopted. Sensitivity analysis was performed to determine the impact of varying levels of uncertainty on the results of this study. Results When compared to chemotherapy alone, the addition of cemiplimab to chemotherapy has been demonstrated to result in an incremental gain of 1.593 QALY at an additional cost of $109351.298. This equates to an incremental cost-effectiveness ratio (ICER) of $68644.883/QALY. One-way sensitivity analyses were conducted on the model, which acknowledged the influence of several parameters, such as subsequent costs, the utility of progressive disease, the cost of best supportive care, the cost of cemiplimab per mg, and the utility of progression-free survival on the outcomes. Nonetheless, none of these parameters yielded an ICER lower than the WTP threshold. Conclusions From the perspective of the United States healthcare system, the utilization of cemiplimab in combination with chemotherapy as a first-line treatment option for NSCLC appears to be a cost-effective approach as compared to using chemotherapy as a standalone therapy.

中文翻译：

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Cemiplimab 联合化疗与化疗治疗晚期非小细胞肺癌：更新的基于 EMPOWER-Lung 3 试验的成本效益分析。

目的 Cemiplimab 联合化疗已成为晚期非小细胞肺癌 (NSCLC) 的一种有前景的治疗选择。因此，本研究旨在从美国医疗保健系统的角度评估这种联合疗法与单独化疗相比的成本效益。方法 本研究基于根据 III 期 EMPOWER-Lung 3 第 2 部分试验的 2 年随访期间获得的临床数据开发的分区生存模型。本调查的目的是通过利用评估成本、质量调整生命年 (QALY) 和增量成本效益比 (ICER) 的主要结果来估计晚期 NSCLC 患者的 10 年预期寿命和总医疗费用。为了确定分析的支付意愿 (WTP) 阈值，采用了 150,000 美元/QALY 的值。进行敏感性分析以确定不同程度的不确定性对本研究结果的影响。结果 与单独化疗相比，化疗中添加 cemiplimab 已被证明可导致 QALY 增量增加 1.593，但额外费用为 109351.298 美元。这相当于增量成本效益比 (ICER) 为 68644.883 美元/QALY。对模型进行了单向敏感性分析，该分析承认几个参数的影响，例如后续成本、疾病进展的效用、最佳支持治疗的成本、每毫克西米普利单抗的成本以及疾病进展的效用。自由生存取决于结果。尽管如此，这些参数都没有产生低于 WTP 阈值的 ICER。结论 从美国医疗保健系统的角度来看，与单独使用化疗相比，使用 cemiplimab 联合化疗作为 NSCLC 的一线治疗选择似乎是一种具有成本效益的方法。