{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T21:41:35Z","timestamp":1780090895087,"version":"3.54.0"},"reference-count":31,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T00:00:00Z","timestamp":1702857600000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,11,13]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate the cost-effectiveness of adding Chinese-developed anti-PD-1 antibody camrelizumab to first-line platinum-doublet chemotherapy in patients with recurrent or metastatic nasopharyngeal carcinoma (L\/M NPC) from the perspective of Chinese healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A Markov model consisting of four health states, progression-free survival, first progression survival, second progression survival and death, was built to simulate 3-week patient transitions over a 20-year horizon. A direct comparison between first-line camrelizumab in combination with gemcitabine plus cisplatin and gemcitabine plus cisplatin was performed by calculating transition probabilities from the CAPTAIN-1st trial. Costs and utilities were collected from the local public database and literature. One-way and probabilistic sensitivity analyses were employed to evaluate the robustness of the model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The Chinese healthcare system perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A hypothetical cohort of Chinese patients with pathologically diagnosed L\/M NPC who had an Eastern Cooperative Oncology Group performance status of 0 or 1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>First-line camrelizumab in combination with camrelizumab and gemcitabine plus cisplatin (CGP) versus gemcitabine plus cisplatin (GP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>Cost, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The baseline analysis demonstrated that, compared with first-line GP, first-line CGP yields an effectiveness increase of 0.26 QALY, accompanied by an increment of US$6137.59 in healthcare cost. This results in an ICER of US$23 482.32\/QALY. With the willingness-to-pay (WTP) threshold for a QALY set at US$37 654.50, first-line CGP proves to be cost-effective in 97.20% of the iterations. Deterministic sensitivity analyses indicated that the uncertainty in model parameters had no substantial effect on our results. Probability sensitivity analysis indicated that CGP was cost-effective at the assumed WTP threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For Chinese patients with L\/M NPC, adding Chinese-developed anti-PD-1 antibody camrelizumab to the first-line GP chemotherapy may be cost-effective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-071832","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T22:35:42Z","timestamp":1702938942000},"page":"e071832","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Cost-effectiveness of camrelizumab combined with chemotherapy in the first-line treatment of recurrent or metastatic nasopharyngeal carcinoma in China"],"prefix":"10.1136","volume":"13","author":[{"given":"Ziying","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Henan Provincial Chest Hospital, Zhengzhou University, Zhengzhou, Henan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0358-9247","authenticated-orcid":false,"given":"Tongfeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Structural Heart Disease, Fuwai Central China Cardiovascular Hospital\/Heart Center of Henan Provincial People's Hospital\/Henan Key Laboratory of Coronary Heart Disease Control\/Henan Research Center for Cardiovascular Epidemiology, Zhengzhou, Henan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0835-8686","authenticated-orcid":false,"given":"Zhen","family":"Zhou","sequence":"additional","affiliation":[{"name":"University of Tasmania Menzies Institute for Medical Research, Hobart, Tasmania, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Henan Provincial Chest Hospital, Zhengzhou University, Zhengzhou, Henan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8739-6236","authenticated-orcid":false,"given":"Qiao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,12,18]]},"reference":[{"key":"2025121221280342000_13.12.e071832.1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31937"},{"key":"2025121221280342000_13.12.e071832.2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"2025121221280342000_13.12.e071832.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30956-0"},{"key":"2025121221280342000_13.12.e071832.4","doi-asserted-by":"crossref","first-page":"21","DOI":"10.21037\/cco.2016.03.03","article-title":"Advances in systemic treatment for nasopharyngeal carcinoma","volume":"5","author":"Tan","year":"2016","journal-title":"Chin Clin Oncol"},{"key":"2025121221280342000_13.12.e071832.5","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1002\/cac2.12218","article-title":"The Chinese society of clinical oncology (CSCO) clinical guidelines for the diagnosis and treatment of nasopharyngeal carcinoma","volume":"41","author":"Tang","year":"2021","journal-title":"Cancer Commun (Lond)"},{"key":"2025121221280342000_13.12.e071832.6","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/5.suppl_3.S87"},{"key":"2025121221280342000_13.12.e071832.7","doi-asserted-by":"publisher","DOI":"10.1007\/s002800050512"},{"key":"2025121221280342000_13.12.e071832.8","first-page":"1717","article-title":"Comparison of five cisplatin-based regimens frequently used as the first-line protocols in metastatic nasopharyngeal carcinoma [published correction appears in J cancer Res Clin Oncol. 2015 Apr;141(4):767]","volume":"141","author":"Jin","year":"2015","journal-title":"J Cancer Res Clin Oncol"},{"key":"2025121221280342000_13.12.e071832.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31388-5"},{"key":"2025121221280342000_13.12.e071832.10","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30495-9"},{"key":"2025121221280342000_13.12.e071832.11","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1016\/S1470-2045(21)00302-8","article-title":"Camrelizumab versus placebo in combination with gemcitabine and cisplatin as first-line treatment for recurrent or metastatic nasopharyngeal carcinoma (CAPTAIN-1St): a multicentre, randomised, double-blind, phase 3 trial","volume":"22","author":"Yang","year":"2021","journal-title":"Lancet Oncol"},{"key":"2025121221280342000_13.12.e071832.12","unstructured":"National Medical Products Administration . 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