{
  "abstract": "Background: Advanced squamous non-small-cell lung cancer (sq-NSCLC) imposes a substantial clinical and economic burden. Immune checkpoint inhibitors (sugemalimab, tislelizumab, penpulimab, serplulimab, camrelizumab, and pembrolizumab) combined with chemotherapy improve survival, but their comparative cost-effectiveness remains uncertain.\n\nMethods: A three-state partitioned survival model with 3-week cycles and a lifetime horizon was developed from the Chinese healthcare-system perspective. Clinical efficacy was derived from six phase 3 trials and synthesized using network meta-analysis. Costs, life-years (LYs), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) for each ICI-based regimen versus chemotherapy were estimated. The willingness‐to‐pay (WTP) threshold was set at $27,906/QALY. Deterministic, probabilistic, scenario, and full incremental analyses were performed.\n\nResults: In the base-case analysis, chemotherapy alone yielded 0.71 QALYs at $12,227.47. All ICI-based regimens increased QALYs to between 1.24 and 2.07. Pembrolizumab plus chemotherapy provided the greatest health benefit, yielding 2.07 QALYs, but had an ICER of $70,913.04 per QALY versus chemotherapy alone. Penpulimab plus chemotherapy had the lowest ICER versus chemotherapy alone ($13,064.23 per QALY), followed by camrelizumab ($13,361.50/QALY), and tislelizumab plus chemotherapy ($14,022.95/QALY), all below the WTP threshold. Sugemalimab plus chemotherapy and serplulimab plus chemotherapy exceeded the threshold. Probabilistic sensitivity analysis indicated that camrelizumab plus chemotherapy had the highest probability of being cost-effective (95%) at $27,906/QALY. In the full incremental analysis, the efficiency frontier comprised chemotherapy alone, penpulimab plus chemotherapy, camrelizumab plus chemotherapy, and pembrolizumab plus chemotherapy; camrelizumab plus chemotherapy was the preferred strategy after dominated options were excluded.\n\nConclusion: At the selected WTP threshold, camrelizumab plus chemotherapy may be the preferred first-line strategy after strictly and extendedly dominated alternatives were excluded. This finding depends on the indirect comparisons, chemotherapy baseline, drug prices, survival extrapolation, and post-progression assumptions.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital",
    "Department of Radiation Oncology, Zhuji Affiliated Hospital of Wenzhou Medical University",
    "Department of Medical Oncology, Zhuji Affiliated Hospital of Wenzhou Medical University"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zijian Qiu"
    },
    {
      "affs": [
        1
      ],
      "name": "Guodong Wang"
    },
    {
      "affs": [
        2
      ],
      "name": "Ying Lou"
    },
    {
      "affs": [
        1
      ],
      "name": "Feng Xuan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/32w8d9y6f4b2k.bib",
  "cited_by": 0,
  "doi": "10.3389/fphar.2026.1841871",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13710048/",
  "id": "32w8d9y6f4b2k",
  "issns": [
    "1663-9812"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1841871/full",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2002|Health Systems, Economic Evaluations, Quality of Life"
    ]
  ],
  "openalex": "W7221615664",
  "pdf_url": "https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2026.1841871/pdf",
  "pmcid": "PMC13710048",
  "pmid": "42947700",
  "published": "2026-10-13",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/32w8d9y6f4b2k.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:06Z",
      "native_id": "10.3389/fphar.2026.1841871",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1841871/full"
    },
    {
      "first_seen": "2026-10-31T12:21:05Z",
      "native_id": "PMC13710048",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fphar.2026.1841871"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1663-9812",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Economic evaluation of six immune checkpoint inhibitor-based first-line therapies for advanced squamous non-small-cell lung cancer: a cost-effectiveness analysis based on network meta-analysis",
  "title_text": "Economic evaluation of six immune checkpoint inhibitor-based first-line therapies for advanced squamous non-small-cell lung cancer: a cost-effectiveness analysis based on network meta-analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:05Z",
  "url": "https://research.draconitic.com/paper/32w8d9y6f4b2k",
  "venue": "Frontiers in Pharmacology",
  "versions": []
}