Cost-effectiveness analysis of dostarlimab plus chemotherapy versus chemotherapy as first-line treatment of metastatic non-squamous non-small cell lung cancer

BACKGROUND: This study evaluates the cost-effectiveness of dostarlimab plus chemotherapy in contrast to chemotherapy as first-line treatment of metastatic non-small cell lung cancer (NSCLC) from the perspective of healthcare payers in the U.S.A. RESEARCH DESIGN AND METHODS: An economic evaluation using a three‑state partitioned survival model assessed the cost-effectiveness of dostarlimab plus chemotherapy compared to chemotherapy alone. The Kaplan-Meier curves for overall survival (OS) and progression-free survival (PFS) from clinical trials were digitally extracted, and the log‑normal model with network meta-analysis (NMA) was applied at the end of the trial to extrapolate long-term survival. The cost and health utility data were sourced from the published literature. RESULTS: The anticipated expenditure for dostarlimab plus chemotherapy therapy exceeded the cost for chemotherapy alone therapy (366,887.33 USD vs 102,503.32 USD). The estimated utility was also greater compared to that of chemotherapy alone treatment (3.74 QALYs vs 1.90 QALYs). The ICER was 143,856.30 USD/QALY. CONCLUSIONS: Dostarlimab plus chemotherapy was cost-effective compared to chemotherapy alone as a first-line treatment for advanced or metastatic NSCLC patients at the WTP threshold of 150,000 USD/QALY in the U.S.A.