Cost-Effectiveness Analysis of Cancer Treatment

In our study, only direct medical costs were considered, including cost of the drug utilization, PD-L1 test, main AEs, treatments for progression (including active treatments and supportive care), monitoring, and terminal care. Drug prices were estimated from the local bid-winning price (Drugdataexpy ). Only severe AEs with great clinical impact, including anemia, neutropenia, and thrombocytopenia, were calculated because they had a relatively considerable influence on the economic evaluation by decreasing quality of life and increasing utilization of health resource. In addition, AE costs were calculated only once in the first cycle.
Costs of monitoring, AEs, terminal care, and PD-L1 tests were obtained from previously published studies (Wu et al., 2012 (link); Zheng et al., 2018 (link); Jiang and Wang, 2020 (link); Wan et al., 2020 (link)). All patients were assumed to incur one-time PD-L1 test costs in the first cycle and one-time terminal care costs before death. Additionally, costs were discounted at an annual rate of 5% (Sanders et al., 2016 (link)). All costs were converted into United States dollars (USD) by exchange rate: 1 USD = 6.47 CYN. All these data are listed in Table 1. If the ICER is below $32,457 threshold (three times GDP per capita of China in 2020, ¥210,000.00), the treatment is generally considered to be cost-effective.