ArticleFrontiers in pharmacology2026
Cost-effectiveness analysis of first-line penpulimab plus chemotherapy for recurrent or metastatic nasopharyngeal carcinoma in China.
Article in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Recurrent or metastatic nasopharyngeal carcinoma (RM-NPC) remains a major health burden in China. Although penpulimab plus chemotherapy has improved clinical outcomes, its economic value remains uncertain. We evaluated the cost-effectiveness of first-line penpulimab plus chemotherapy versus placebo plus chemotherapy from the perspective of the Chinese healthcare system. Methods: A partitioned survival model was developed to compare penpulimab plus chemotherapy with chemotherapy alone in patients with RM-NPC. The main outcomes included total costs, life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), incremental net monetary benefit (INMB), and incremental net health benefit (INHB). One-way, two-way, probabilistic, price simulation, scenario and subgroup analyses were performed. Results: Compared with placebo plus chemotherapy, penpulimab plus chemotherapy increased total costs by $ 5,841.38 and generated gains of 0.29 LYs and 0.25 QALYs, yielding an ICER of $23,717.68/QALY. At a willingness-to-pay threshold of $27,906/QALY, the regimen produced a positive INMB of $1,031.53 and a positive INHB of 0.04 QALYs. Sensitivity analyses identified progression-free survival utility, penpulimab cost, and discount rate as the most influential parameters. Only variation in progression-free survival utility increased the ICER above the threshold. The probability of cost-effectiveness was 79.0% at the 2× gross domestic product threshold and 99.2% at the 3× threshold. Penpulimab plus chemotherapy remained cost-effective across all scenario analyses and evaluable subgroups. Conclusion: From the perspective of the Chinese healthcare system, first-line penpulimab plus chemotherapy is likely to be a cost-effective treatment strategy for patients with RM-NPC compared with placebo plus chemotherapy.
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