Pembrolizumab combined with Chemotherapy versus placebo combined with Chemotherapy for HER2-negative advanced gastric cancer in China:A cost-effectiveness analysis

ABSTRACT

Objective

This study aims to conduct a cost-effectiveness analysis of pembrolizumab in combination with chemotherapy for HER2-negative advanced gastric cancer in China.

Methods

A partitioned survival approach model was constructed to simulate the progression of HER2-negative advanced gastric cancer and evaluate the outcomes of different treatment strategies. We calculated incremental cost-effectiveness ratios (ICER) to assess the cost associated with each quality-adjusted life-year (QALY) gained. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to assess robustness and reliability.

Results

The analysis conducted in the base case demonstrated that the ICER associated with pembrolizumab was $177405.83/QALY gained in all population. In the subgroup analysis, it was found that individuals with a PD-L1 CPS ≥ 1 and those with a PD-L1 CPS ≥ 10 had ICERs of $152397.06/QALY and $109534.13/QALY, respectively. All ICER values for both the all population groups and the subgroups exceeded the WTP threshold in China. Our analysis shows the robustness of these results, as they remained consistent when input parameters were varied within a ± 25% range.

Conclusion

The findings of this cost-effectiveness analysis suggest that pembrolizumab in combination with chemotherapy is not a cost-effective treatment option for HER2-negative advanced gastric cancer in China.

KEYWORDS:

• Cost-effectiveness analysis
• pembrolizumab
• chemotherapy
• HER2-negative
• advanced gastric cancer

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Author Contributions

Z Zheng and H Cai conceptualized and designed this research. X Song, H Cai and H Zhu collected study data. Z Zheng and H Cai analyzed and interpreted the data. Z Zheng drafted the manuscript, all authors were responsible for manuscript revisions. All authors approved the final submission and agreed to be accountable for all aspects of the work.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2024.2378986

Availability of data and material

The data employed in this study can be provided upon reasonable inquiry to the corresponding author.

Additional information

Funding

This paper was not funded