Cost-effectiveness analysis of sintilimab versus docetaxel as second-line therapy for squamous non-small cell lung Cancer in China

There is a scarcity of pharmacoeconomic information in China regarding utilising sintilimab as the second-line therapy for squamous non-small cell lung cancer (NSCLC). This study aimed to estimate the cost-effectiveness of sintilimab compared with docetaxel for treating squamous NSCLC in China. A partitioned survival model was developed using data from the phase III ORIENT-3 trial (NCT 03150875), which randomised patients 1:1 to receive sintilimab (200 mg every 3 weeks) or docetaxel (75 mg/m2 every 3 weeks). Efficacy and safety data, costs and utilities were derived from the trial, the published literature and local databases. Sensitivity analyses assessed model robustness. Sintilimab provided an additional 0.32 quality-adjusted life years (QALYs) at an incremental cost of $2,789.52 versus docetaxel, resulting in an incremental cost-effectiveness ratio of $8,717.25/QALY, below China’s 2024 per capita gross domestic product ($12,961.80). Grade ≥ 3 adverse events included decreased neutrophil count (23.85% with docetaxel vs 0% with sintilimab) and white blood cell count (19.23% vs 0%). Sensitivity analyses confirmed robust results across all willingness-to-pay thresholds. Sintilimab is cost-effective as a second-line therapy for advanced squamous NSCLC in China. Limitations include utility data from the literature rather than trial patients and lack of post-progression treatment details.