{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T23:26:36Z","timestamp":1784589996418,"version":"3.55.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T00:00:00Z","timestamp":1693440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>For patients with extensive-stage small cell lung cancer (ES-SCLC), serplulimab plus chemotherapy is beneficial as the first-line treatment. It is uncertain whether serplulimab plus chemotherapy will be more cost-effective. The aim of this study was to evaluate from the perspective of the Chinese healthcare system to assess the cost-effectiveness of serplulimab plus chemotherapy for patients with ES-SCLC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>This study employed a partitioned survival model. Patients in the model were selected from ASTRUM-005 for their clinical characteristics and outcomes. In order to assess the robustness of the model, we conducted deterministic one-way sensitivity analyzes as well as probabilistic sensitivity analyzes. Subgroup analyzes were also conducted. Costs, quality-adjusted life-years (QALYs), life-years, incremental cost-effectiveness ratio (ICER), incremental net health benefits (INHB), and incremental net monetary benefits (INMB) were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on the base-case analysis, serplulimab plus chemotherapy contributed to an increase in 0.826 life-years and 0.436 QALYs; an incremental cost of $52,331, yielded ICER of $120,149\/QALY. Based on the willingness to pay (WTP) threshold of $37,669\/QALY and $86,569\/QALY, the INHB was \u22120.954 QALYs and\u2009\u2212\u20090.169 QALYs and the INMB was -$35,924 and -$14,626, respectively. Based on the probabilistic sensitivity analysis results, serplulimab plus chemotherapy was unlikely to be cost-effective at a WTP threshold of $37,669\/QALY and $86,569\/QALY. One-way sensitivity analysis indicated that cost of serplulimab and body weight had the greatest impact on the model. Serplulimab plus chemotherapy could be cost-effective at a WTP threshold of $86,569\/QALY when the cost of serplulimab was less than $5.24\/mg or when the weight of the patient was less than 40.96\u2009kg. Regardless of the WTP threshold at $37,669\/QALY or $86,569. Serplulimab plus chemotherapy was not cost-effective in all subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Serplulimab plus chemotherapy was not cost-effective, despite having a prior clinical benefical and a relative safety profile compared with chemotherapy. With the reduction in the price of serplulimab, ES-SCLC patients treated with serplulimab plus chemotherapy may be able to achieve a favorable cost-effectiveness rate.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1156427","type":"journal-article","created":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T12:03:07Z","timestamp":1693483387000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Cost-effectiveness analysis of first-line serplulimab combined with chemotherapy for extensive-stage small cell lung cancer"],"prefix":"10.3389","volume":"11","author":[{"given":"Xueyan","family":"Liang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","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":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2945","DOI":"10.7150\/jca.75622","article-title":"A 2022 update on extensive stage small-cell lung Cancer (Sclc)","volume":"13","author":"Oronsky","year":"2022","journal-title":"J Cancer"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1038\/s41572-020-00235-0","article-title":"Small-Cell Lung Cancer","volume":"7","author":"Rudin","year":"2021","journal-title":"Nat Rev Dis Primers"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1200\/jco.21.01881","article-title":"Extensive-stage small-cell lung Cancer: first-line and second-line treatment options","volume":"40","author":"Zugazagoitia","year":"2022","journal-title":"J Clin Oncol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1002\/cncr.29098","article-title":"Small cell lung Cancer: where do we go from Here?","volume":"121","author":"Byers","year":"2015","journal-title":"Cancer"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1016\/j.jtho.2021.12.014","article-title":"The 2021 who classification of tumors of the pleura: advances since the 2015 classification","volume":"17","author":"Sauter","year":"2022","journal-title":"J Thorac Oncol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1038\/nrc.2017.87","article-title":"Small-cell lung Cancer: what we know, what we need to know and the path forward","volume":"17","author":"Gazdar","year":"2017","journal-title":"Nat Rev Cancer"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2243","DOI":"10.1002\/ijc.34346","article-title":"Extensive-stage small-cell lung Cancer: current management and future directions","volume":"152","author":"Yu","year":"2022","journal-title":"Int J Cancer"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1183\/09031936.00105009","article-title":"Treatment of extensive-stage small cell lung carcinoma: current status and future prospects","volume":"35","author":"Demedts","year":"2010","journal-title":"Eur Respir J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1200\/jco.21.01845","article-title":"Managing resistance to immune checkpoint inhibitors in lung Cancer: treatment and novel strategies","volume":"40","author":"Passaro","year":"2022","journal-title":"J Clin Oncol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2220","DOI":"10.1056\/NEJMoa1809064","article-title":"First-line Atezolizumab plus chemotherapy in extensive-stage small-cell lung Cancer","volume":"379","author":"Horn","year":"2018","journal-title":"N Engl J Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1016\/s0140-6736(19)32222-6","article-title":"Durvalumab plus platinum-etoposide versus platinum-etoposide in first-line treatment of extensive-stage small-cell lung Cancer (Caspian): a randomised, controlled, open-label, phase 3 trial","volume":"394","author":"Paz-Ares","year":"2019","journal-title":"Lancet"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"2369","DOI":"10.1200\/jco.20.00793","article-title":"Pembrolizumab or placebo plus etoposide and platinum as first-line therapy for extensive-stage small-cell lung Cancer: randomized, double-blind, phase iii Keynote-604 study","volume":"38","author":"Rudin","year":"2020","journal-title":"J Clin Oncol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1001\/jama.2022.16464","article-title":"Effect of first-line Serplulimab vs placebo added to chemotherapy on survival in patients with extensive-stage small cell lung Cancer: the ASTRUM-005 randomized clinical trial","volume":"328","author":"Cheng","year":"2022","journal-title":"JAMA"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e067975","DOI":"10.1136\/bmj-2021-067975","article-title":"Consolidated health economic evaluation reporting standards 2022 (Cheers 2022) statement: updated reporting guidance for health economic evaluations","volume":"376","author":"Husereau","year":"2022","journal-title":"BMJ"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1177\/0272989x16670617","article-title":"Estimation of survival probabilities for use in cost-effectiveness analyses: a comparison of a multi-state modeling survival analysis approach with partitioned survival and Markov decision-analytic modeling","volume":"37","author":"Williams","year":"2017","journal-title":"Med Decis Mak"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"3995","DOI":"10.1002\/cncr.34457","article-title":"Atezolizumab plus bevacizumab versus Nivolumab as first-line treatment for advanced or Unresectable hepatocellular carcinoma: a cost-effectiveness analysis","volume":"128","author":"Li","year":"2022","journal-title":"Cancer"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"878054","DOI":"10.3389\/fonc.2022.878054","article-title":"Pembrolizumab vs Cemiplimab for the treatment of advanced non-small cell lung Cancer with Pd-L1 expression levels of at least 50%: a network Meta-analysis and cost-effectiveness analysis","volume":"12","author":"Li","year":"2022","journal-title":"Front Oncol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"906956","DOI":"10.3389\/fphar.2022.906956","article-title":"Nivolumab versus Sorafenib as first-line therapy for advanced hepatocellular carcinoma: a cost-effectiveness analysis","volume":"13","author":"Li","year":"2022","journal-title":"Front Pharmacol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/1471-2288-12-9","article-title":"Enhanced secondary analysis of survival data: reconstructing the data from published Kaplan-Meier survival curves","volume":"12","author":"Guyot","year":"2012","journal-title":"BMC Med Res Methodol"},{"key":"ref21","unstructured":"2023"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1136\/ejhpharm-2020-002208","article-title":"Cost-effectiveness analysis of Pembrolizumab plus standard chemotherapy versus chemotherapy alone for first-line treatment of metastatic non-squamous non-small-cell lung Cancer in China","volume":"29","author":"Jiang","year":"2022","journal-title":"Eur J Hosp Pharm"},{"key":"ref23","doi-asserted-by":"publisher","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":"Wu","year":"2012","journal-title":"PLoS One"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e0196007","DOI":"10.1371\/journal.pone.0196007","article-title":"Assessment of costs associated with adverse events in patients with Cancer","volume":"13","author":"Wong","year":"2018","journal-title":"PLoS One"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1007\/s12094-017-1715-1","article-title":"Cost-effectiveness analysis of the addition of bevacizumab to chemotherapy as induction and maintenance therapy for metastatic non-squamous non-small-cell lung Cancer","volume":"20","author":"Zheng","year":"2018","journal-title":"Clin Transl Oncol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1186\/s40425-018-0440-9","article-title":"Cost-effectiveness of Nivolumab plus Ipilimumab as first-line therapy in advanced renal-cell carcinoma","volume":"6","author":"Wu","year":"2018","journal-title":"J Immunother Cancer"},{"key":"ref27","unstructured":"2023"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"740091","DOI":"10.3389\/fonc.2021.740091","article-title":"First-line treatments for extensive-stage small-cell lung Cancer with immune checkpoint inhibitors plus chemotherapy: a network Meta-analysis and cost-effectiveness analysis","volume":"11","author":"Kang","year":"2021","journal-title":"Front Oncol"},{"key":"ref29","doi-asserted-by":"publisher","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":"Nafees","year":"2017","journal-title":"Asia Pac J Clin Oncol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta19910","article-title":"Fluorouracil plasma monitoring: systematic review and economic evaluation of the My5-Fu assay for guiding dose adjustment in patients receiving fluorouracil chemotherapy by continuous infusion","volume":"19","author":"Freeman","year":"2015","journal-title":"Health Technol Assess"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jval.2020.09.014","article-title":"Assessing the value of Cemiplimab for adults with advanced cutaneous squamous cell carcinoma: a cost-effectiveness analysis","volume":"24","author":"Konidaris","year":"2021","journal-title":"Value Health"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"735536","DOI":"10.3389\/fphar.2021.735536","article-title":"Cost-effectiveness analysis of Camrelizumab plus chemotherapy vs. chemotherapy alone as the first-line treatment in patients with Iiib-iv non-squamous non-small cell lung Cancer (Nsclc) without Egfr and Alk alteration from a perspective of health - care system in China","volume":"12","author":"Zhu","year":"2021","journal-title":"Front Pharmacol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1446","DOI":"10.1016\/j.clinthera.2011.09.016","article-title":"Cost-effectiveness of adding Rh-Endostatin to first-line chemotherapy in patients with advanced non-small-cell lung Cancer in China","volume":"33","author":"Wu","year":"2011","journal-title":"Clin Ther"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1111\/j.1524-4733.2004.75003.x","article-title":"Use of cost-effectiveness analysis in health-care resource allocation decision-making: how are cost-effectiveness thresholds expected to emerge?","volume":"7","author":"Eichler","year":"2004","journal-title":"Value Health"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"2790","DOI":"10.1097\/cm9.0000000000000536","article-title":"First-line Atezolizumab plus chemotherapy in treatment of extensive small cell lung Cancer: a cost-effectiveness analysis from China","volume":"132","author":"Li","year":"2019","journal-title":"Chin Med J"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1080\/14737167.2021.1888717","article-title":"Cost-effectiveness of adding Durvalumab to first-line chemotherapy for extensive-stage small-cell lung Cancer in China","volume":"22","author":"Liu","year":"2022","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"e0258605","DOI":"10.1371\/journal.pone.0258605","article-title":"Cost-effectiveness analysis of Pembrolizumab plus chemotherapy as first-line therapy for extensive-stage small-cell lung Cancer","volume":"16","author":"Liu","year":"2021","journal-title":"PLoS One"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/s12962-021-00329-w","article-title":"First-line Pembrolizumab plus chemotherapy for extensive-stage small-cell lung Cancer: a United States-based cost-effectiveness analysis","volume":"19","author":"Zhu","year":"2021","journal-title":"Cost. Eff. Resour. Alloc."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1019826","DOI":"10.3389\/fphar.2022.1019826","article-title":"Cost-effectiveness analysis of Adebrelimab combined with chemotherapy for extensive-stage small cell lung Cancer","volume":"13","author":"You","year":"2022","journal-title":"Front Pharmacol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1044678","DOI":"10.3389\/fimmu.2022.1044678","article-title":"Serplulimab plus chemotherapy as first-line treatment for extensive-stage small-cell lung cancer: a cost-effectiveness analysis","volume":"13","author":"Zhu","year":"2023","journal-title":"Front Immunol"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.1016\/j.jval.2020.08.2094","article-title":"Partitioned survival and state transition models for healthcare decision making in oncology: where are we now?","volume":"23","author":"Woods","year":"2020","journal-title":"Value Health"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1258\/135581907779497567","article-title":"Searching for a threshold, not setting one: the role of the National Institute for health and clinical excellence","volume":"12","author":"Culyer","year":"2007","journal-title":"J Health Serv Res Policy"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"733","DOI":"10.2165\/00019053-200826090-00004","article-title":"The NICE cost-effectiveness threshold: what it is and what that means","volume":"26","author":"McCabe","year":"2008","journal-title":"PharmacoEconomics"},{"key":"ref44","unstructured":""}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1156427\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T12:03:10Z","timestamp":1693483390000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1156427\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,31]]},"references-count":44,"alternative-id":["10.3389\/fpubh.2023.1156427"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1156427","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,31]]},"article-number":"1156427"}}