{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T17:38:27Z","timestamp":1776361107456,"version":"3.51.2"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017594","name":"Medical Science and Technology Project of Zhejiang Province","doi-asserted-by":"publisher","award":["2022KY090"],"award-info":[{"award-number":["2022KY090"]}],"id":[{"id":"10.13039\/501100017594","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Zhejiang Pharmaceutical Society's Clinical Comprehensive Evaluation of Drugs Special Research Funding Project","award":["2022ZYYL11"],"award-info":[{"award-number":["2022ZYYL11"]}]},{"name":"Project of Health Economics and Health Technology Assessment from Zhejiang Pharmaceutical Association","award":["2022ZYJ18"],"award-info":[{"award-number":["2022ZYJ18"]}]},{"name":"Medical Health Science and Technology Project of Zhejiang province","award":["2023KY608"],"award-info":[{"award-number":["2023KY608"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>We aimed to investigate the cost-effectiveness of tislelizumab plus chemotherapy compared to chemotherapy alone as a first-line treatment for advanced or metastatic oesophageal squamous cell carcinoma (OSCC).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A partitioned survival model was developed to evaluate the cost-effectiveness of tislelizumab plus chemotherapy versus chemotherapy alone in patients with advanced or metastatic OSCC over a 10-year lifetime horizon from the perspective of the Chinese healthcare system. Costs and utilities were derived from the drug procurement platform and published literature. The model outcomes comprised of costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were conducted to address uncertainty and ensure the robustness of the model.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Tislelizumab plus chemotherapy yielded an additional 0.337 QALYs and incremental costs of $7,117.007 compared with placebo plus chemotherapy, generating an ICER of $21,116.75 per QALY, which was between 1 time ($12,674.89\/QALY) and 3 times GDP ($38,024.67\/QALY) per capita. In one-way sensitivity analysis, the ICER is most affected by the cost of oxaliplatin, paclitaxel and tislelizumab. In the probabilistic sensitivity analysis, when the willingness-to-pay threshold was set as 1 or 3 times GDP per capita, the probability of tislelizumab plus chemotherapy being cost-effective was 1% and 100%, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Tislelizumab plus chemotherapy was probably cost-effective compared with chemotherapy alone as the first-line treatment for advanced or metastatic OSCC in China.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302961","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T17:39:46Z","timestamp":1715794786000},"page":"e0302961","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cost-effectiveness analysis of tislelizumab plus chemotherapy as the first-line treatment for advanced or metastatic oesophageal squamous cell carcinoma in China"],"prefix":"10.1371","volume":"19","author":[{"given":"Chaoneng","family":"He","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiufang","family":"Mi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaoqi","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinglu","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenxiu","family":"Xin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Like","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junfeng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Shu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luo","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4896-3976","authenticated-orcid":true,"given":"Haiying","family":"Ding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,5,15]]},"reference":[{"issue":"3","key":"pone.0302961.ref001","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"H Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"issue":"9","key":"pone.0302961.ref002","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1136\/gutjnl-2020-321600","article-title":"Global burden of oesophageal and gastric cancer by histology and subsite in 2018","volume":"69","author":"M Arnold","year":"2020","journal-title":"Gut"},{"issue":"1","key":"pone.0302961.ref003","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.jncc.2023.01.002","article-title":"Patterns and trends in esophageal cancer incidence and mortality in China: An analysis based on cancer registry data","volume":"3","author":"R Chen","year":"2023","journal-title":"Journal of the National Cancer Center"},{"issue":"10","key":"pone.0302961.ref004","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1002\/cac2.12197","article-title":"Cancer incidence, mortality, and burden in China: a time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020","volume":"41","author":"H Qiu","year":"2021","journal-title":"Cancer Commun (Lond)"},{"issue":"10204","key":"pone.0302961.ref005","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1016\/S0140-6736(19)30427-1","article-title":"Mortality, morbidity, and risk factors in China and its provinces, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"394","author":"M Zhou","year":"2019","journal-title":"Lancet"},{"key":"pone.0302961.ref006","doi-asserted-by":"crossref","first-page":"1171671","DOI":"10.3389\/fimmu.2023.1171671","article-title":"Clinical benefits of PD-1 inhibitors in specific subgroups of patients with advanced esophageal squamous cell carcinoma: a systematic review and meta-analysis of phase 3 randomized clinical trials","volume":"14","author":"Y Lu","year":"2023","journal-title":"Front Immunol"},{"issue":"7","key":"pone.0302961.ref007","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1200\/JCO.22.02331","article-title":"Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline","volume":"41","author":"MA Shah","year":"2023","journal-title":"J Clin Oncol"},{"key":"pone.0302961.ref008","doi-asserted-by":"crossref","first-page":"1055727","DOI":"10.3389\/fphar.2023.1055727","article-title":"Cost-effectiveness analysis of PD-1 inhibitors combined with chemotherapy as first-line therapy for advanced esophageal squamous-cell carcinoma in China","volume":"14","author":"S Liu","year":"2023","journal-title":"Front Pharmacol"},{"issue":"10","key":"pone.0302961.ref009","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.annonc.2022.07.003","article-title":"Oesophageal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"33","author":"R Obermannova","year":"2022","journal-title":"Ann Oncol"},{"issue":"4","key":"pone.0302961.ref010","doi-asserted-by":"crossref","first-page":"393","DOI":"10.6004\/jnccn.2023.0019","article-title":"Esophageal and Esophagogastric Junction Cancers, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology","volume":"21","author":"JA Ajani","year":"2023","journal-title":"J Natl Compr Canc Netw"},{"issue":"1","key":"pone.0302961.ref011","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1093\/annonc\/mdy498","article-title":"Pan-Asian adapted ESMO Clinical Practice Guidelines for the management of patients with metastatic oesophageal cancer: a JSMO-ESMO initiative endorsed by CSCO, KSMO, MOS, SSO and TOS","volume":"30","author":"K Muro","year":"2019","journal-title":"Ann Oncol"},{"issue":"5","key":"pone.0302961.ref012","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1056\/NEJMoa2111380","article-title":"Nivolumab Combination Therapy in Advanced Esophageal Squamous-Cell Carcinoma","volume":"386","author":"Y Doki","year":"2022","journal-title":"N Engl J Med"},{"key":"pone.0302961.ref013","doi-asserted-by":"crossref","first-page":"e068714","DOI":"10.1136\/bmj-2021-068714","article-title":"Sintilimab versus placebo in combination with chemotherapy as first line treatment for locally advanced or metastatic oesophageal squamous cell carcinoma (ORIENT-15): multicentre, randomised, double blind, phase 3 trial","volume":"377","author":"Z Lu","year":"2022","journal-title":"BMJ"},{"issue":"10","key":"pone.0302961.ref014","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1001\/jama.2021.12836","article-title":"Effect of Camrelizumab vs Placebo Added to Chemotherapy on Survival and Progression-Free Survival in Patients With Advanced or Metastatic Esophageal Squamous Cell Carcinoma: The ESCORT-1st Randomized Clinical Trial","volume":"326","author":"H Luo","year":"2021","journal-title":"JAMA"},{"issue":"3","key":"pone.0302961.ref015","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.ccell.2022.02.007","article-title":"Toripalimab plus chemotherapy in treatment-naive, advanced esophageal squamous cell carcinoma (JUPITER-06): A multi-center phase 3 trial","volume":"40","author":"ZX Wang","year":"2022","journal-title":"Cancer Cell"},{"issue":"10302","key":"pone.0302961.ref016","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/S0140-6736(21)01234-4","article-title":"Pembrolizumab plus chemotherapy versus chemotherapy alone for first-line treatment of advanced oesophageal cancer (KEYNOTE-590): a randomised, placebo-controlled, phase 3 study","volume":"398","author":"JM Sun","year":"2021","journal-title":"Lancet"},{"issue":"2","key":"pone.0302961.ref017","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1038\/s41591-022-02179-2","article-title":"First-line serplulimab or placebo plus chemotherapy in PD-L1-positive esophageal squamous cell carcinoma: a randomized, double-blind phase 3 trial","volume":"29","author":"Y Song","year":"2023","journal-title":"Nat Med"},{"issue":"5","key":"pone.0302961.ref018","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/S1470-2045(23)00108-0","article-title":"Tislelizumab plus chemotherapy versus placebo plus chemotherapy as first-line treatment for advanced or metastatic oesophageal squamous cell carcinoma (RATIONALE-306): a global, randomised, placebo-controlled, phase 3 study","volume":"24","author":"J Xu","year":"2023","journal-title":"Lancet Oncol"},{"key":"pone.0302961.ref019","unstructured":"Chinese Society of Clinical Oncology (CSCO). CSCO guidelines: esophageal cancer. Beijing: People\u2019s Medical Publishing House. 2023."},{"issue":"2","key":"pone.0302961.ref020","doi-asserted-by":"crossref","first-page":"e210037","DOI":"10.1001\/jamanetworkopen.2021.0037","article-title":"Cost-effectiveness of Atezolizumab Plus Bevacizumab vs Sorafenib as First-Line Treatment of Unresectable Hepatocellular Carcinoma","volume":"4","author":"D Su","year":"2021","journal-title":"JAMA Netw Open"},{"key":"pone.0302961.ref021","unstructured":"G. L, S. H, J. W, J. W. China guidelines for pharmacoeconomic evaluations (2020). Beijing: China Market Press. 2020."},{"issue":"2","key":"pone.0302961.ref022","doi-asserted-by":"crossref","first-page":"118","DOI":"10.2471\/BLT.14.138206","article-title":"Thresholds for the cost-effectiveness of interventions: alternative approaches","volume":"93","author":"E Marseille","year":"2015","journal-title":"Bull World Health Organ"},{"key":"pone.0302961.ref023","doi-asserted-by":"crossref","first-page":"1092385","DOI":"10.3389\/fimmu.2023.1092385","article-title":"Cost-effectiveness of sintilimab plus chemotherapy versus chemotherapy alone as first-line treatment of locally advanced or metastatic oesophageal squamous cell carcinoma","volume":"14","author":"L Liu","year":"2023","journal-title":"Front Immunol"},{"key":"pone.0302961.ref024","first-page":"2816737","article-title":"Cost-Effectiveness and Budget Impact Analysis of Apatinib for Advanced Metastatic Gastric Cancer from the Perspective of Health Insurance System","volume":"2017","author":"Y Bai","year":"2017","journal-title":"Gastroenterol Res Pract"},{"issue":"3","key":"pone.0302961.ref025","doi-asserted-by":"crossref","first-page":"e32530","DOI":"10.1371\/journal.pone.0032530","article-title":"Economic evaluation of first-line treatments for metastatic renal cell carcinoma: a cost-effectiveness analysis in a health resource-limited setting","volume":"7","author":"B Wu","year":"2012","journal-title":"PLoS One"},{"key":"pone.0302961.ref026","doi-asserted-by":"crossref","first-page":"790373","DOI":"10.3389\/fonc.2021.790373","article-title":"Cost-Effectiveness Analysis of Camrelizumab vs. Placebo Added to Chemotherapy as First-Line Therapy for Advanced or Metastatic Esophageal Squamous Cell Carcinoma in China","volume":"11","author":"Q Zhang","year":"2021","journal-title":"Front Oncol"},{"key":"pone.0302961.ref027","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1186\/1471-2407-14-984","article-title":"Cost-effectiveness analysis of adjuvant chemotherapies in patients presenting with gastric cancer after D2 gastrectomy","volume":"14","author":"B Wu","year":"2014","journal-title":"BMC Cancer"},{"issue":"5","key":"pone.0302961.ref028","doi-asserted-by":"crossref","first-page":"e195","DOI":"10.1111\/ajco.12477","article-title":"Health state utilities in non-small cell lung cancer: An international study","volume":"13","author":"B Nafees","year":"2017","journal-title":"Asia Pac J Clin Oncol"},{"key":"pone.0302961.ref029","doi-asserted-by":"crossref","first-page":"893387","DOI":"10.3389\/fpubh.2022.893387","article-title":"Cost-Effectiveness Analysis of Pembrolizumab Plus Chemotherapy vs. Chemotherapy Alone as First-Line Treatment in Patients With Esophageal Squamous Cell Carcinoma and PD-L1 CPS of 10 or More","volume":"10","author":"Z Zheng","year":"2022","journal-title":"Front Public Health"},{"key":"pone.0302961.ref030","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.vhri.2020.07.580","article-title":"Current Development and Practice of Pharmacoeconomic Evaluation Guidelines for Universal Health Coverage in China","volume":"24","author":"X Yue","year":"2021","journal-title":"Value Health Reg Issues"},{"issue":"5","key":"pone.0302961.ref031","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1177\/0272989X12458348","article-title":"Model parameter estimation and uncertainty analysis: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force Working Group-6","volume":"32","author":"AH Briggs","year":"2012","journal-title":"Med Decis Making"},{"key":"pone.0302961.ref032","doi-asserted-by":"crossref","first-page":"961347","DOI":"10.3389\/fphar.2022.961347","article-title":"Economic evaluation of tislelizumab versus chemotherapy as second-line treatment for advanced or metastatic esophageal squamous cell carcinoma in China","volume":"13","author":"F Shi","year":"2022","journal-title":"Front Pharmacol"},{"key":"pone.0302961.ref033","doi-asserted-by":"crossref","first-page":"941738","DOI":"10.3389\/fpubh.2022.941738","article-title":"Cost-effectiveness analysis of pembrolizumab vs. chemotherapy as second-line treatment for advanced esophageal carcinoma in the United States","volume":"10","author":"J Hu","year":"2022","journal-title":"Front Public Health"},{"key":"pone.0302961.ref034","doi-asserted-by":"crossref","first-page":"923619","DOI":"10.3389\/fpubh.2022.923619","article-title":"Cost-Effectiveness of Nivolumab Immunotherapy vs. Paclitaxel or Docetaxel Chemotherapy as Second-Line Therapy in Advanced Esophageal Squamous Cell Carcinoma in China","volume":"10","author":"YT Lin","year":"2022","journal-title":"Front Public Health"},{"key":"pone.0302961.ref035","doi-asserted-by":"crossref","first-page":"790225","DOI":"10.3389\/fpubh.2022.790225","article-title":"Cost-Effectiveness Analysis of Pembrolizumab in Patients With Advanced Esophageal Cancer Based on the KEYNOTE-181 Study","volume":"10","author":"M Zhan","year":"2022","journal-title":"Front Public Health"},{"key":"pone.0302961.ref036","doi-asserted-by":"crossref","first-page":"1172242","DOI":"10.3389\/fimmu.2023.1172242","article-title":"Cost-effectiveness analysis of serplulimab plus chemotherapy in the first-line treatment for PD-L1-positive esophageal squamous cell carcinoma in China","volume":"14","author":"S Liu","year":"2023","journal-title":"Front Immunol"},{"issue":"6","key":"pone.0302961.ref037","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1080\/14737167.2023.2214732","article-title":"Cost-effectiveness of camrelizumab plus chemotherapy versus chemotherapy alone as first-line therapy in advanced or metastatic esophageal squamous cell carcinoma","volume":"23","author":"J Gong","year":"2023","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"issue":"13","key":"pone.0302961.ref038","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.2217\/imt-2023-0059","article-title":"Cost-effectiveness analysis of serplulimab as first-line treatment for advanced esophageal squamous cell carcinoma","volume":"15","author":"Z Zheng","year":"2023","journal-title":"Immunotherapy"},{"issue":"6","key":"pone.0302961.ref039","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1080\/14737167.2023.2206570","article-title":"Economic evaluation of toripalimab plus chemotherapy compared with chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma in China","volume":"23","author":"Z Zheng","year":"2023","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"issue":"3","key":"pone.0302961.ref040","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1007\/s11096-023-01540-w","article-title":"Cost-effectiveness of toripalimab plus chemotherapy for advanced esophageal squamous cell carcinoma","volume":"45","author":"K Xu","year":"2023","journal-title":"Int J Clin Pharm"},{"key":"pone.0302961.ref041","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.2147\/RMHP.S436750","article-title":"Cost-Effectiveness Analysis of Tislelizumab Plus Chemotherapy as First-Line Treatment for Advanced or Metastatic Esophageal Squamous Cell Carcinoma in China","volume":"16","author":"C Zhou","year":"2023","journal-title":"Risk Manag Healthc Policy"},{"issue":"8","key":"pone.0302961.ref042","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/s40261-023-01295-2","article-title":"Tislelizumab Plus Chemotherapy Versus Placebo Plus Chemotherapy as First-Line Treatment for Chinese Patients with Advanced Esophageal Squamous Cell Carcinoma: A Cost-Effectiveness Analysis","volume":"43","author":"S Lu","year":"2023","journal-title":"Clin Drug Investig"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0302961","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T17:40:13Z","timestamp":1715794813000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0302961"}},"subtitle":[],"editor":[{"given":"Gang","family":"Qin","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,5,15]]},"references-count":42,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,15]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0302961","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,15]]}}}