Toripalimab plus chemotherapy in American patients with recurrent or metastatic nasopharyngeal carcinoma: A cost-effectiveness analysis.

BACKGROUND: Toripalimab, combined with gemcitabine and cisplatin, has been approved as the first-line treatment for recurrent or metastatic nasopharyngeal carcinoma (RM-NPC), representing a significant milestone as the first FDA-approved innovative therapy for this condition. Despite this achievement, there's a lack of data on the cost-effectiveness of toripalimab for RM-NPC patients in the American context. METHODS: To assess the cost-effectiveness of toripalimab plus chemotherapy versus chemotherapy alone, a 3-state partitioned survival model was constructed. The study involved participants with characteristics matching those in the JUPITER-02 trial. Cost and utility inputs were collected from literature. Main outcomes measured were quality-adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER). Univariate and probabilistic sensitivity analyses, subgroup analyses, and scenario analyses were conducted to verify the robustness of results. RESULTS: The study found that the toripalimab regimen resulted in 4.390 QALYs at a cost of $361,813, while the chemotherapy-only regimen yielded 1.685 QALYs at a cost of $161,632. This translates to an ICER of $74,004/QALY, below the willingness-to-pay threshold of $150,000/QALY. Sensitivity analyses indicated that utility values, discount rate, and the price of toripalimab significantly impact INMB. With an 87.10% probability of being cost-effective at a $150,000/QALY threshold, the probabilistic sensitivity analysis supports toripalimab plus chemotherapy as a viable option. Scenario analysis showed that toripalimab remains cost-effective unless its price increases by 125%. Additionally, a simulated 15-year study period increases the ICER to $88,026/QALY. Subgroup analysis revealed ICERs of $76,538/QALY for PD-L1 positive and $70,158/QALY for PD-L1 negative groups. CONCLUSIONS: Toripalimab in combination with chemotherapy is likely to be a cost-effective alternative to standard chemotherapy for American patients with RM-NPC. This evidence can guide clinical and reimbursement decision-making in treating RM-NPC patients.

The quality of published health economic evaluations on screening programs in China: a systematic review and quantitative appraisal.

BACKGROUND: This study seeks to assess the quality of HEEs reporting on screening programs over the last 20 years in China, to identify potential predictors of reporting quality. METHODS: We performed a literature search of HEE studies published in PubMed, Embase, CNKI, and WANFANG from 2000 to 2021. The search terms included 'screening,' 'China,' 'CEA,' 'CBA,' 'CUA,' and all other names for health economic evaluation. Two reviewers independently extracted data and assessed the reporting quality using CHEERS checklist. A generalized linear regression analysis was used to identify the predictors of reporting quality. RESULTS: 133 of 1,281 identified studies was included. The reporting quality scores showed an increasing trend and the mean score was 0.56. Some items were underreported, such as study perspective, discount rate, measurement of effectiveness, analytical methods, uncertainty, heterogeneity etc. Five factors (year of publication, journal type, first author's affiliation, economic evaluation type, specialty journals or not) predicted a higher score of reporting quality in the regression analyses (P < 0.05). CONCLUSIONS: Overall, the quality of HEEs on screening programs in China showed an improving trend. Given the significance of reporting quality, it is advisable to report HEE results following standard evaluation guidelines to improve their transparency.

Facile synthesis of 1-thio-beta-lactoside clusters scaffolded onto p-methoxyphenyl, beta-D-galactopyranoside, beta-D-glucopyranoside, and lactoside.

The free-radical addition of 2,3,4,6-tetra-O-acetyl-beta-D-galactopyranosyl-(1-->4)-2,3,6-tri-O-acetyl-1-thio-beta-D-glucopyranose to the allyl ether functions of p-methoxyphenyl per-O-allyl-D-galactopyranoside, D-glucopyranoside, and lactoside provides a concise and effective route for synthesis of glycoside clusters, of use for exploring anti-metastatic activity.

Remote heart sound monitoring system.

A kind of remote monitoring system on heart sound is constructed, which can tele-monitor ECG and PCG. The system integrates embedded internet technology and wireless technology. As it can send ECG and PCG by internet, it realizes real-time recording and monitoring of physiology parameter of patients at low cost and both at home and in hospital, and it also can be used for analysis for computer or reference for doctor. This study demonstrated that such kind of tele-monitoring system provides a low-cost, reliable and convenient solution for data acquisition and analysis of the PCG.