LAUSR

Background To evaluate the cost-effectiveness of camrelizumab versus chemotherapy for patients with advanced or metastatic esophageal squamous cell carcinoma (ESCC) from the perspective of health system and to provide a basis for health decisions in China. Methods A Markov model of 3 health states throughout the lifetime was established based on data from the ESCORT trial. Life-years, quality-adjusted life-years (QALYs), and lifetime costs were estimated. The time horizon of lifetime was 5 years and each model cycle represented 2 months. The cost and utility value adopted a 5% discount rate per year. One-way sensitivity analysis and probability sensitivity analysis were used to test the robustness of the results. Results The results of the cost-effectiveness analysis revealed that the camrelizumab group produced a gain of 2.93 QALY, at a cost of $37,809.12 USD, and the chemotherapy group gained 2.85 QALY, at a cost of $3,7071.52 USD. Camrelizumab was more cost-effective than chemotherapy for patients with advanced or metastatic ESCC. The results of one-way sensitivity analyses showed that the cost of camrelizumab, cost of chemotherapy and utility of progression-free survival (PFS) state were the top three parameters influencing the model. The probability sensitivity analysis results showed that the results of the basic case analysis were stable. Conclusions Under the willingness to pay threshold of three times per capita GDP of China, camrelizumab as second-line treatment could provide more health benefits for advanced or metastatic ESCC in China.