Cost analysis
death, ESCC
DISEASE
A Markov‐based state transition model was established to simulate the clinical status of patients with inoperable ESCC (Figure Diagram of transition states in Markov model. In the Markov model, 3 transition states of “disease‐free survival,” “relapse,” and “death” were used to simulate the disease process of the patient after radiotherapy. The model is structured over the time horizon of lifetime. 1‐year cycle length was used. CCRT, concurrent chemoradiotherapy; NTF, nasogastric tube feeding; ONS, oral nutritional supplements; PEG, percutaneous endoscopic gastrostomy.Cost included the following expenditure: radiotherapy, chemotherapy, nutrition support cost, treatment of major AEs costs, and hospitalization cost. Each price of these costs is based on our center. To compare the costs of different enteral nutrition supplement groups, healthcare costs during the initial 3 months and 6 months after the start of radiotherapy were analyzed. All costs were adjusted to US dollars with an exchange rate of $1 = ¥6.37 (December 7, 2021).The cost‐effectiveness analysis followed the guidelines of the Second Panel on Cost‐Effectiveness in Health and Medicine.One‐way sensitivity analysis was performed to estimate the impact of different model parameters on the ICER. A probabilistic sensitivity analysis was performed to assess the uncertainty of the ICER estimate by using Monte Carlo simulation from 10,000 samples at different hypothetical willingness to pay (WTP) thresholds. The outcomes were reported as cost‐effectiveness probability for $10,000 per QALY and $50,000 per QALY as well as cost‐effectiveness acceptability curves. We applied international standards to define a strategy as “cost‐effective” if its ICER was below three times the gross domestic product (GDP) per capita in China (2020 annual: $33,962).