Shixian Liu, Kaixuan Wang, Ruixue Wang, Hao Chen, Ziming Wan, Lei Dou, Shunping Li
{"title":"卡多尼莫单抗联合化疗一线治疗her2阴性晚期胃或胃食管交界处腺癌的成本-效果","authors":"Shixian Liu, Kaixuan Wang, Ruixue Wang, Hao Chen, Ziming Wan, Lei Dou, Shunping Li","doi":"10.1177/17562848251366946","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The COMPASSION-15 clinical trial demonstrated that cadonilimab plus chemotherapy significantly improved clinical benefits in human epidermal growth factor receptor 2-negative (HER2-) advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma.</p><p><strong>Objectives: </strong>This study investigated the cost-effectiveness of cadonilimab plus chemotherapy in the first-line treatment for HER2- advanced G/GEJ adenocarcinoma from the Chinese healthcare system perspective.</p><p><strong>Design: </strong>Economic evaluation.</p><p><strong>Methods: </strong>We compared three treatment regimens based on the COMPASSION-15 trial, including chemotherapy, cadonilimab plus chemotherapy, and programmed death ligand 1 (PD-L1) test-guided treatment. A partitioned survival model was constructed at 21-day cycle lengths over a 10-year time horizon to predict total costs, life-years, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) under the willingness-to-pay (WTP) threshold of three times the gross domestic product per capita ($40,334.05). Model parameters were obtained from a public bid-winning database and published literature. Scenario, one-way, and probabilistic sensitivity analyses were used to test the robustness of the model.</p><p><strong>Results: </strong>In the base case, the costs of chemotherapy, PD-L1 test-guided treatment, and cadonilimab plus chemotherapy were $7,207.78, $15,776.35, and $22,294.58, with QALYs of 0.59, 0.71, and 0.79, respectively. The ICERs of PD-L1 test-guided treatment and cadonilimab plus chemotherapy were $68,751.00 and $76,120.27 per QALY. The ICERs of cadonilimab plus chemotherapy were $58,469.16 and $121,123.92 per QALY for PD-L1 combined positive score (CPS) ⩾ 5 and <5 HER2- advanced G/GEJ adenocarcinoma. The cost of cadonilimab and patient weight were the most influential model parameters. Cadonilimab plus chemotherapy had a 0.01% cost-effectiveness in China.</p><p><strong>Conclusion: </strong>Cadonilimab plus chemotherapy might be a cost-effective regimen when the unit cost of cadonilimab was $151.48 (58% discount) and $188.04 (72% discount) for overall and PD-L1 CPS ⩾ 5 advanced G/GEJ adenocarcinoma.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251366946"},"PeriodicalIF":3.4000,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12365449/pdf/","citationCount":"0","resultStr":"{\"title\":\"Cost-effectiveness of cadonilimab plus chemotherapy in the first-line treatment of HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma.\",\"authors\":\"Shixian Liu, Kaixuan Wang, Ruixue Wang, Hao Chen, Ziming Wan, Lei Dou, Shunping Li\",\"doi\":\"10.1177/17562848251366946\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The COMPASSION-15 clinical trial demonstrated that cadonilimab plus chemotherapy significantly improved clinical benefits in human epidermal growth factor receptor 2-negative (HER2-) advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma.</p><p><strong>Objectives: </strong>This study investigated the cost-effectiveness of cadonilimab plus chemotherapy in the first-line treatment for HER2- advanced G/GEJ adenocarcinoma from the Chinese healthcare system perspective.</p><p><strong>Design: </strong>Economic evaluation.</p><p><strong>Methods: </strong>We compared three treatment regimens based on the COMPASSION-15 trial, including chemotherapy, cadonilimab plus chemotherapy, and programmed death ligand 1 (PD-L1) test-guided treatment. A partitioned survival model was constructed at 21-day cycle lengths over a 10-year time horizon to predict total costs, life-years, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) under the willingness-to-pay (WTP) threshold of three times the gross domestic product per capita ($40,334.05). Model parameters were obtained from a public bid-winning database and published literature. Scenario, one-way, and probabilistic sensitivity analyses were used to test the robustness of the model.</p><p><strong>Results: </strong>In the base case, the costs of chemotherapy, PD-L1 test-guided treatment, and cadonilimab plus chemotherapy were $7,207.78, $15,776.35, and $22,294.58, with QALYs of 0.59, 0.71, and 0.79, respectively. The ICERs of PD-L1 test-guided treatment and cadonilimab plus chemotherapy were $68,751.00 and $76,120.27 per QALY. The ICERs of cadonilimab plus chemotherapy were $58,469.16 and $121,123.92 per QALY for PD-L1 combined positive score (CPS) ⩾ 5 and <5 HER2- advanced G/GEJ adenocarcinoma. The cost of cadonilimab and patient weight were the most influential model parameters. Cadonilimab plus chemotherapy had a 0.01% cost-effectiveness in China.</p><p><strong>Conclusion: </strong>Cadonilimab plus chemotherapy might be a cost-effective regimen when the unit cost of cadonilimab was $151.48 (58% discount) and $188.04 (72% discount) for overall and PD-L1 CPS ⩾ 5 advanced G/GEJ adenocarcinoma.</p>\",\"PeriodicalId\":48770,\"journal\":{\"name\":\"Therapeutic Advances in Gastroenterology\",\"volume\":\"18 \",\"pages\":\"17562848251366946\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-08-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12365449/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Gastroenterology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17562848251366946\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17562848251366946","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Cost-effectiveness of cadonilimab plus chemotherapy in the first-line treatment of HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma.
Background: The COMPASSION-15 clinical trial demonstrated that cadonilimab plus chemotherapy significantly improved clinical benefits in human epidermal growth factor receptor 2-negative (HER2-) advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma.
Objectives: This study investigated the cost-effectiveness of cadonilimab plus chemotherapy in the first-line treatment for HER2- advanced G/GEJ adenocarcinoma from the Chinese healthcare system perspective.
Design: Economic evaluation.
Methods: We compared three treatment regimens based on the COMPASSION-15 trial, including chemotherapy, cadonilimab plus chemotherapy, and programmed death ligand 1 (PD-L1) test-guided treatment. A partitioned survival model was constructed at 21-day cycle lengths over a 10-year time horizon to predict total costs, life-years, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) under the willingness-to-pay (WTP) threshold of three times the gross domestic product per capita ($40,334.05). Model parameters were obtained from a public bid-winning database and published literature. Scenario, one-way, and probabilistic sensitivity analyses were used to test the robustness of the model.
Results: In the base case, the costs of chemotherapy, PD-L1 test-guided treatment, and cadonilimab plus chemotherapy were $7,207.78, $15,776.35, and $22,294.58, with QALYs of 0.59, 0.71, and 0.79, respectively. The ICERs of PD-L1 test-guided treatment and cadonilimab plus chemotherapy were $68,751.00 and $76,120.27 per QALY. The ICERs of cadonilimab plus chemotherapy were $58,469.16 and $121,123.92 per QALY for PD-L1 combined positive score (CPS) ⩾ 5 and <5 HER2- advanced G/GEJ adenocarcinoma. The cost of cadonilimab and patient weight were the most influential model parameters. Cadonilimab plus chemotherapy had a 0.01% cost-effectiveness in China.
Conclusion: Cadonilimab plus chemotherapy might be a cost-effective regimen when the unit cost of cadonilimab was $151.48 (58% discount) and $188.04 (72% discount) for overall and PD-L1 CPS ⩾ 5 advanced G/GEJ adenocarcinoma.
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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