AI Insight
This cost-effectiveness analysis evaluated atezolizumab combined with bevacizumab and chemotherapy versus bevacizumab with chemotherapy for treating metastatic, persistent, or recurrent cervical cancer in China. Using a 10-year Markov model based on the BEATcc trial, researchers found that the combination therapy provided an additional 0.54 quality-adjusted life-years but cost an extra $233,602.51, resulting in an incremental cost-effectiveness ratio of $432,597.24 per QALY gained. This exceeds China's willingness-to-pay threshold of $36,859 per QALY by more than tenfold, indicating the treatment is not cost-effective in the Chinese healthcare system.
Why it matters
This analysis provides crucial evidence for healthcare decision-makers in China regarding resource allocation for cervical cancer treatment. While the combination therapy offers modest survival benefits, its prohibitively high cost relative to China's economic standards suggests it may not be suitable for widespread implementation without significant price reductions or alternative funding mechanisms.
by Shuo Yang, Yibing Hou, Xiaohui Wang, Shuo Kang, Zhenhua Pan
Background
From China’s healthcare perspective, this analysis compared the cost-effectiveness of Atezolizumab in combination with Bevacizumab and chemotherapy for Metastatic, Persistent, or Recurrent Cervical Cancer.
Methods
A Markov model was developed to track patients’ transitions over 3-week cycles and evaluate the health and economic outcomes over a 10-year horizon for the two competing treatments. The survival data were gathered from the BEATcc trial, and cost and utility values were obtained from the published studies. Total costs, life-years, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) were the model outcomes. Sensitivity analyzes were performed to examine the robustness of the model results.
Results
In the base case, atezolizumab plus bevacizumab and chemotherapy yielded a marginal cost of $233,602.51 and an additional 0.54 QALYs, resulting in an ICER of $432,597.24 per additional QALY gained, which exceeded the willingness-to-pay (WTP) threshold of $36,859 in China. Sensitivity analyzes confirmed the robustness of the model outcomes.
Conclusions
Atezolizumab plus bevacizumab and chemotherapy was not a cost-effective treatment for patients with metastatic, persistent, or recurrent cervical cancer compared with bevacizumab plus chemotherapy from the perspective of the Chinese health-care system.