Objective This study aimed to determine the value-based price range at which tislelizumab combined with chemotherapy becomes cost-effective compared with chemotherapy alone for treating advanced oesophageal squamous cell carcinoma. Design We constructed a three-state Markov model over a lifetime horizon, following the same protocols in the RATIONALE-306 trial. One-way and probabilistic sensitivity analyses were performed to assess model robustness. Settings US healthcare system, payer perspective. Primary and secondary outcome measures The primary outcome of the model included value-based per-cycle price of tislelizumab at willingness-to-pay thresholds from US50 000 to US200 000 per quality-adjusted life-year (QALY). Secondary outcomes were life years and QALY over life-time horizon. Interventions Tislelizumab+chemotherapy versus chemotherapy alone followed by second-line paclitaxel in both arms. Results Tislelizumab resulted in a gain of 0. 543 QALYs (95% CI 0. 432 to 0. 610) and 0. 837 life-years (95% CI 0. 780 to 0. 915) compared with chemotherapy alone. The value-based price of tislelizumab was determined to be US1575 to US7160 per cycle when the willingness to pay threshold was set at US50 000–US200 000 per QALY. Sensitivity analyses confirmed the model’s robustness at these price points across various model parameters. Conclusions This study established a value-based price range for tislelizumab in oesophageal squamous cell carcinoma treatment using robust economic modelling. These findings can be used to guide payers in coverage decisions and inform pricing negotiations for emerging immunotherapies.
ABDEEN et al. (Fri,) studied this question.