Chinese healthcare faces a critical assessment as recent findings reveal that the combination of ivonescimab and chemotherapy may not offer a financially viable treatment option for patients battling advanced nonasquamous non-small cell lung cancer (nsq-NSCLC) with EGFR mutations.
Study Overview and Methodology
The multicenter phase 3 HARMONi-A study, registered under NCT05184712, highlighted significant improvements in progression-free survival (PFS) when ivonescimab was paired with chemotherapy following epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatments. Building on these results, researchers employed a decision-embedded Markov model to evaluate the long-term economic and health impacts of this combination therapy compared to chemotherapy alone over a decade. Key metrics analyzed included life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and incremental net health benefits (INHBs). Comprehensive sensitivity analyses and subgroup cohort analyses ensured the robustness of the findings.
Key Inferences from the Analysis
– The high cost of ivonescimab significantly drives the unfavorable ICER.
– Even with variations in model parameters, the cost-effectiveness remains below the acceptable threshold.
– The current pricing strategy lacks alignment with the willingness-to-pay (WTP) benchmarks in China.
– Alternative funding or pricing adjustments are essential to improve economic viability.
Economic Outcomes and Implications
Economic evaluations revealed that the ivonescimab and chemotherapy combination costs $41,354, yielding 0.90 QALYs. In contrast, chemotherapy alone costs $35,166 with an additional 0.13 QALYs. This disparity results in an ICER of $277,594 per QALY, starkly exceeding China’s WTP threshold of $36,997 per QALY. The analysis pinpointed the cost of ivonescimab as the primary factor influencing the ICER, although the overall model remained consistent across various parameter changes.
For stakeholders, these results underscore the necessity for price negotiations or the implementation of subsidy programs to make the ivonescimab-chemotherapy regimen a viable option for patients. Without such measures, the financial burden may outweigh the clinical benefits, limiting access to this potentially life-extending treatment.
Navigating the balance between innovative cancer treatments and their affordability remains a pressing challenge. Policymakers and healthcare providers must collaborate to ensure that advancements in therapy translate into accessible and sustainable patient care solutions.

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