PCN73 Cost-Effectiveness of Pembrolizumab Versus Chemotherapy for Advanced Esophageal Squamous Cell Carcinoma (ESCC) As the Second-LINE Treatment Among the Chinese Population

The KEYNOTE-181 study has demonstrated the prolonged survival benefits of pembrolizumab compared with chemotherapy as second-line treatment among Chinese patients ESCC. This aimed to assess cost-effectiveness versus advanced ESCC who failed first-line treatment. We developed a Markov model simulate progression through three health status (progression-free survival, progressed disease, and death). Time-varying transitional probabilities were estimated using patient-level data from study. Utility direct medical costs in China, measured US dollars(USD), obtained published literature. Costs standardized 2020 value consumer price index for supply. simulation was conducted life-time window 3% annual discount rate cost utility. incremental ratio(ICER) system perspective. performed one-way sensitivity analyses robustness results, subgroup analysis cohort exclusively. effectiveness 0.09 QALY 37,082USD, resulting an ICER 390,509USD/QALY. found uncertainties disease utility had biggest impact on pembrolizumab. When Chinese-only used, be 0.44 43,047USD, 97,229USD/QALY. Based willingness-to-pay threshold 25,841USD (three times GDP) commonly used is currently not cost-effective option chemotherapy.