Cost-effectiveness of dostarlimab plus chemotherapy for primary advanced or recurrent endometrial cancer
ObjectiveIn the double-blind, phase III, placebo-controlled RUBY randomized clinical trial, dostarlimab plus carboplatin-paclitaxel significantly increased survival among patients with primary advanced or recurrent endometrial cancer (EC). We conducted a cost-effectiveness analysis of dostarlimab in...
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| Формат: | Статья |
| Язык: | English |
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Frontiers Media S.A.
2024-06-01
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| Серии: | Frontiers in Pharmacology |
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| Online-ссылка: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1391896/full |
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| author | Gengwei Huo Gengwei Huo Gengwei Huo Gengwei Huo Ying Song Wei Liu Wei Liu Wei Liu Wei Liu Hua Guo Hua Guo Hua Guo Hua Guo Peng Chen Peng Chen Peng Chen Peng Chen |
| author_facet | Gengwei Huo Gengwei Huo Gengwei Huo Gengwei Huo Ying Song Wei Liu Wei Liu Wei Liu Wei Liu Hua Guo Hua Guo Hua Guo Hua Guo Peng Chen Peng Chen Peng Chen Peng Chen |
| author_sort | Gengwei Huo |
| collection | DOAJ |
| description | ObjectiveIn the double-blind, phase III, placebo-controlled RUBY randomized clinical trial, dostarlimab plus carboplatin-paclitaxel significantly increased survival among patients with primary advanced or recurrent endometrial cancer (EC). We conducted a cost-effectiveness analysis of dostarlimab in combination with chemotherapy in these patients stratified by mismatch repair-deficient (dMMR) and mismatch repair-proficient (pMMR) subgroups from the perspective of a United States payer.Materials and methodsA Markov model with three states was employed to simulate patients who were administered either dostarlimab in combination with chemotherapy or chemotherapy based on the RUBY trial. Quality-adjusted life-years (QALYs), lifetime costs, and incremental cost-effectiveness ratio (ICER) were calculated with a willingness-to-pay (WTP) threshold of $150,000 per QALY. Both univariate and probabilistic sensitivity analyses were carried out to explore the robustness of the model.ResultsIn dMMR EC, the combination of dostarlimab and chemotherapy achieved an additional 5.48 QALYs at an incremental cost of $330,747 compared to chemotherapy alone, resulting in an ICER of $60,349.30 per QALY. In pMMR EC, there were 1.51 additional QALYs gained at an extra cost of $265,148, yielding an ICER of $175,788.47 per QALY. With a 15.2% discount on dostarlimab, the ICER decreased to $150,000 per QALY in the pMMR EC. The univariate sensitivity analysis revealed that the cost of dostarlimab, utility of progression-free survival (PFS), and progressive disease (PD) had the most significant impacts on the outcomes. Probabilistic sensitivity analysis revealed that dostarlimab had a 100% likelihood of being considered cost-effective for patients at a WTP threshold of $150,000 per QALY for dMMR EC, whereas this likelihood was only 0.5% for pMMR EC.ConclusionDostarlimab in combination with chemotherapy was cost-effective for primary advanced or recurrent dMMR EC from the perspective of a United States payer at a WTP threshold of $150,000 per QALY, but not for pMMR EC. Lowering the prices of dostarlimab could potentially enhance the cost-effectiveness of treatment for pMMR EC. |
| first_indexed | 2025-03-21T15:11:18Z |
| format | Article |
| id | doaj.art-ac901b614fb1480da4680709d138000f |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2025-03-21T15:11:18Z |
| publishDate | 2024-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pharmacology |
| spelling | doaj.art-ac901b614fb1480da4680709d138000f2024-06-20T05:10:05ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122024-06-011510.3389/fphar.2024.13918961391896Cost-effectiveness of dostarlimab plus chemotherapy for primary advanced or recurrent endometrial cancerGengwei Huo0Gengwei Huo1Gengwei Huo2Gengwei Huo3Ying Song4Wei Liu5Wei Liu6Wei Liu7Wei Liu8Hua Guo9Hua Guo10Hua Guo11Hua Guo12Peng Chen13Peng Chen14Peng Chen15Peng Chen16Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, ChinaNational Clinical Research Center for Cancer, Tianjin, ChinaKey Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin, ChinaTianjin’s Clinical Research Center for Cancer, Tianjin, ChinaDepartment of Pharmacy, Jining No.1 People’s Hospital, Jining, Shandong, ChinaDepartment of Tumor Cell Biology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, ChinaNational Clinical Research Center for Cancer, Tianjin, ChinaKey Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin, ChinaTianjin’s Clinical Research Center for Cancer, Tianjin, ChinaDepartment of Tumor Cell Biology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, ChinaNational Clinical Research Center for Cancer, Tianjin, ChinaKey Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin, ChinaTianjin’s Clinical Research Center for Cancer, Tianjin, ChinaDepartment of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, ChinaNational Clinical Research Center for Cancer, Tianjin, ChinaKey Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin, ChinaTianjin’s Clinical Research Center for Cancer, Tianjin, ChinaObjectiveIn the double-blind, phase III, placebo-controlled RUBY randomized clinical trial, dostarlimab plus carboplatin-paclitaxel significantly increased survival among patients with primary advanced or recurrent endometrial cancer (EC). We conducted a cost-effectiveness analysis of dostarlimab in combination with chemotherapy in these patients stratified by mismatch repair-deficient (dMMR) and mismatch repair-proficient (pMMR) subgroups from the perspective of a United States payer.Materials and methodsA Markov model with three states was employed to simulate patients who were administered either dostarlimab in combination with chemotherapy or chemotherapy based on the RUBY trial. Quality-adjusted life-years (QALYs), lifetime costs, and incremental cost-effectiveness ratio (ICER) were calculated with a willingness-to-pay (WTP) threshold of $150,000 per QALY. Both univariate and probabilistic sensitivity analyses were carried out to explore the robustness of the model.ResultsIn dMMR EC, the combination of dostarlimab and chemotherapy achieved an additional 5.48 QALYs at an incremental cost of $330,747 compared to chemotherapy alone, resulting in an ICER of $60,349.30 per QALY. In pMMR EC, there were 1.51 additional QALYs gained at an extra cost of $265,148, yielding an ICER of $175,788.47 per QALY. With a 15.2% discount on dostarlimab, the ICER decreased to $150,000 per QALY in the pMMR EC. The univariate sensitivity analysis revealed that the cost of dostarlimab, utility of progression-free survival (PFS), and progressive disease (PD) had the most significant impacts on the outcomes. Probabilistic sensitivity analysis revealed that dostarlimab had a 100% likelihood of being considered cost-effective for patients at a WTP threshold of $150,000 per QALY for dMMR EC, whereas this likelihood was only 0.5% for pMMR EC.ConclusionDostarlimab in combination with chemotherapy was cost-effective for primary advanced or recurrent dMMR EC from the perspective of a United States payer at a WTP threshold of $150,000 per QALY, but not for pMMR EC. Lowering the prices of dostarlimab could potentially enhance the cost-effectiveness of treatment for pMMR EC.https://www.frontiersin.org/articles/10.3389/fphar.2024.1391896/fulldostarlimabendometrial cancerMarkov modelRUBYcost-effectiveness |
| spellingShingle | Gengwei Huo Gengwei Huo Gengwei Huo Gengwei Huo Ying Song Wei Liu Wei Liu Wei Liu Wei Liu Hua Guo Hua Guo Hua Guo Hua Guo Peng Chen Peng Chen Peng Chen Peng Chen Cost-effectiveness of dostarlimab plus chemotherapy for primary advanced or recurrent endometrial cancer Frontiers in Pharmacology dostarlimab endometrial cancer Markov model RUBY cost-effectiveness |
| title | Cost-effectiveness of dostarlimab plus chemotherapy for primary advanced or recurrent endometrial cancer |
| title_full | Cost-effectiveness of dostarlimab plus chemotherapy for primary advanced or recurrent endometrial cancer |
| title_fullStr | Cost-effectiveness of dostarlimab plus chemotherapy for primary advanced or recurrent endometrial cancer |
| title_full_unstemmed | Cost-effectiveness of dostarlimab plus chemotherapy for primary advanced or recurrent endometrial cancer |
| title_short | Cost-effectiveness of dostarlimab plus chemotherapy for primary advanced or recurrent endometrial cancer |
| title_sort | cost effectiveness of dostarlimab plus chemotherapy for primary advanced or recurrent endometrial cancer |
| topic | dostarlimab endometrial cancer Markov model RUBY cost-effectiveness |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1391896/full |
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