A recent analysis reveals that the combination of cadonilimab and chemotherapy (CAD-CHM) does not present a cost-effective first-line treatment option for patients with HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma within the Chinese healthcare system.
Study Overview and Methodology
The evaluation was based on data from the COMPASSION-15 trial, which compared CAD-CHM to placebo plus chemotherapy (PLA-CHM). Researchers developed a Markov model encompassing three health states to determine the cost-effectiveness of the treatment. This model incorporated drug costs derived from national tender prices and additional expenses and utility values from existing literature sources. The study examined both the overall patient population and specific subgroups categorized by programmed death ligand 1 (PD-L1) combined positive score (CPS) of 5 and below.
Key Findings and Determinants
- CAD-CHM’s incremental cost-effectiveness ratio (ICER) surpasses the acceptable threshold across all patient groups.
- Patient weight, the cost of cadonilimab, and the utility value of progression-free survival significantly impact the model outcomes.
- The probability of CAD-CHM being cost-effective remains at 0% when compared to PLA-CHM.
The study found that the ICER for CAD-CHM stands at $67,378.09 per quality-adjusted life-year (QALY) in the general population. This figure drops to $48,433.34 per QALY for patients with a PD-L1 CPS of 5 or higher but rises to $78,463.86 per QALY for those with a CPS below 5. All these values exceed the willingness-to-pay threshold of $41,511 per QALY set by the Chinese healthcare system.
The analysis underscores the financial challenges associated with introducing cadonilimab into standard treatment protocols for advanced gastric cancer. Despite clinical benefits observed in the COMPASSION-15 trial, the economic burden is not justified under current healthcare budget constraints.
Healthcare policymakers and stakeholders must weigh these findings when considering the adoption of CAD-CHM. Future efforts could focus on negotiating drug prices or identifying patient subgroups that may derive greater economic and clinical benefits from the treatment.
Implementing cost-effective strategies is crucial to ensure sustainable healthcare delivery. This study provides valuable insights into the economic implications of new cancer therapies, guiding informed decision-making to optimize resource allocation and patient outcomes.
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