Aims: Assessing the cost-effectiveness of Nivolumab with Gemcitabine-Cisplatin for Advanced Urothelial Carcinoma (aUC) treatment from the perspective of Chinese payers.
Methods: A Markov model assessed economic outcomes, estimating health outcomes in quality-adjusted life years (QALYs). One-way and probabilistic sensitivity analyses were conducted to assess the impact of uncertainties on the results.
Results: The base-case analysis showed Nivolumab plus Gemcitabine-Cisplatin yielded 0.59 QALYs at an extra cost of $78,780.61, leading to an incremental cost-effectiveness ratios (ICER) of $133,526.46/QALY. One-way sensitivity analysis highlighted Nivolumab's cost as the key factor, while probabilistic sensitivity analysis showed a 0% chance of cost-effectiveness for Nivolumab plus Gemcitabine-Cisplatin in aUC treatment.
Conclusion: Nivolumab plus Gemcitabine-Cisplatin is not cost-effective in the treatment of aUC.
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http://dx.doi.org/10.3389/fphar.2024.1382342 | DOI Listing |
Ther Adv Med Oncol
December 2024
Department of Pharmacy, Fujian Medical University Union Hospital, Xinquan Road 29, Fuzhou, Fujian 350001, China.
Background: Urothelial carcinoma is a significant health concern in the United States (US), with high mortality and economic burdens. The CheckMate-901 trial showed promising survival benefits for nivolumab combined with gemcitabine and cisplatin followed by nivolumab maintenance therapy (nivolumab-combination) as first-line treatment of unresectable or metastatic urothelial carcinoma (UC), but its cost-effectiveness is unclear.
Objectives: This study aimed to evaluate the cost-effectiveness of the nivolumab-combination versus standard chemotherapy (gemcitabine-cisplatin) for advanced UC from the perspective of healthcare payers in the US.
Front Oncol
November 2024
Department of Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czechia.
Introduction: Platinum-based chemotherapy followed by the immune checkpoint inhibitor avelumab represents an intensified upfront therapy regimen that may result in significant downstaging and, subsequently, potentially radical robotic nephroureterectomy with a lymph node dissection, an uncommon approach with an unexpectedly favorable outcome.
Case Presentation: We report a case of a 70-year-old female presented with a sizeable cN2+ tumor of the left renal pelvis and achieved deep partial radiologic response after systemic therapy with four cycles of gemcitabine-cisplatin chemotherapy followed by avelumab maintenance therapy and subsequent robotic resection of the tumor. The patient continued with adjuvant nivolumab therapy once recovered after surgery and remained tumor-free on the subsequent follow-up.
Front Pharmacol
November 2024
Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China.
Aims: Assessing the cost-effectiveness of Nivolumab with Gemcitabine-Cisplatin for Advanced Urothelial Carcinoma (aUC) treatment from the perspective of Chinese payers.
Methods: A Markov model assessed economic outcomes, estimating health outcomes in quality-adjusted life years (QALYs). One-way and probabilistic sensitivity analyses were conducted to assess the impact of uncertainties on the results.
Eur Urol Oncol
October 2024
Department of Urology, Urologic Oncology, Robot-Assisted and Specialized Urologic Surgery, University of Cologne, Cologne, Germany; Department of Urology, Medical University Vienna, Vienna, Austria.
Background And Objective: Metastatic urothelial carcinoma (mUCa) ranks as the costliest cancer to treat per patient due to frequent interventions and expensive follow-ups. Investigating first-line therapies, combinations such as enfortumab vedotin + pembrolizumab (EV + P) and gemcitabine/cisplatin + nivolumab exhibit significant overall survival benefits compared with the standard treatment (SoC; gemcitabine/cisplatin). Here, we conducted a cost-effectiveness analysis for mUCa.
View Article and Find Full Text PDFFront Immunol
September 2024
Department of Pharmacy, Daping Hospital, Army Medical University, Chongqing, China.
Objective: Nivolumab, recently proven in a phase 3 clinical trial (CheckMate 901) to enhance survival when combined with gemcitabine-cisplatin for advanced urothelial carcinoma. This study aimed to assess its cost-effectiveness against gemcitabine-cisplatin alone, from US and Chinese payers' perspectives.
Methods: A partitioned survival model was established to assess the life-years, quality-adjusted life-years (QALYs), lifetime costs, and incremental cost-effectiveness ratios (ICERs) of nivolumab plus gemcitabine-cisplatin versus gemcitabine-cisplatin alone as first-line treatment for advanced urothelial carcinoma.
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