ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1524108
Cost-effectiveness evaluation of benmelstobart, anlotinib and chemotherapy in patients with extensive-stage small-cell lung cancer
Provisionally accepted
- 1Shandong Second Provincial General Hospital, Jinan, China
- 2Linyi University, Linyi, Shandong Province, China
- 3Shandong Medical College, Jinan, China
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Programmed death-ligand 1 (PD-L1) blockade is a growing treatment for extensive-stage small cell lung cancer (ES-SCLC). This study evaluates the cost-effectiveness of benmelstobart and anlotinib plus etoposide/carboplatin (EC) compared versus anlotinib plus EC and EC alone for patients with ES-SCLC in China. Using a Markov model over 5-year boundary and data from the ETER701 trials, we analyzed quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER), total cost, incremental net health benefit (INHB) and incremental monetary benefit (INMB). To address uncertainties, we conducted one-way analysis and probabilistic sensitivity analysis (PSA). Scenario analyses were used to evaluate the resilience of our model's findings. The administration of triple therapy for ES-SCLC demonstrated a significant improvement in QALY, with respective gains of 0.26, 0.39, compared with the other two schemes. However, enhanced therapeutic benefit was accompanied by increased costs. And triple therapy showed less cost-effectiveness with ICER of $189797.99 and $149249.24 per QALY respectively when compared with other schemes.Moreover, the analysis revealed an INHB of -1.04, -1.12 QALYs, and the INMB of -39755.48 $, -42819.93 $ respectively. Sensitivity analysis demonstrated that benmelstobart's cost was the main driver of cost-effectiveness. The cost-effectiveness acceptability curve displayed that the likelihood of triple therapy being cost-effective increased from 34.20% to 97.60% when the threshold value for cost per QALY gained varied from $180000 to $240000. The scenario analysis supported these findings. Triple therapy was a less cost-effective option for patients with ES-SCLC compared with anlotinib plus EC and EC alone in China.
Keywords: extensive-stage small-cell lung cancer, benmelstobart, Anlotinib, Carboplatin, Etoposide, Cost-Effectiveness
Received: 07 Nov 2024; Accepted: 30 Jul 2025.
Copyright: © 2025 Jing, Kou, Tang, Dai, Zhao and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiyong Wu, Shandong Second Provincial General Hospital, Jinan, China
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