Cost-effectiveness analysis of zolbetuximab plus mFOLFOX6 as the first-line treatment for CLDN18.2-positive, HER2-negative advanced gastric or Gastroesophageal Adenocarcinoma

Frontiers in Pharmacology

Pharmacology

Ruijia Chen¹  Yufan Huang²  Maojin You²  Qundan Wu³ 

[1] Department of Pharmacy, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China;Department of Pharmacy, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, China;Department of Pharmacy, Quanzhou Skin Disease Prevention and Treatment Hospital, Quanzhou, Fujian, China;

关键词: cost-effectiveness;    zolbetuximab;    CLDN18.2-positive;    HER2-negative;    gastric or gastroesophageal adenocarcinoma;    first-line treatment;   

DOI  :  10.3389/fphar.2023.1238009

 received in 2023-06-10, accepted in 2023-07-27,  发布年份 2023

来源: Frontiers

【 摘 要 】

Background: The SPOTLIGHT trial demonstrated that zolbetuximab plus mFOLFOX6 (ZOL-FO) as a first-line regimen compared with placebo plus mFOLFOX6 (PLB-FO) conferred clinical benefits to patients with CLDN18.2-positive, HER2-negative advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma. However, due to the high cost of zolbetuximab, whether ZOL-FO is cost-effective compared with PLB-FO is unclear. This study aimed to evaluate the cost-effectiveness of ZOL-FO as a first-line treatment option for CLDN18.2-positive, HER2-negative advanced G/GEJ adenocarcinoma from the perspective of the Chinese healthcare system.Methods: Markov models with three different health states were developed to assess the cost-effectiveness of ZOL-FO as a first-line treatment option for CLDN18.2-positive, HER2-negative advanced G/GEJ adenocarcinoma. Clinical efficacy data were obtained from the SPOTLIGHT trial; the drug’s cost was calculated at national bid prices, and other costs and utility values were obtained from the published literature. Outcomes included total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). The model’s robustness was verified using one-way sensitivity and probabilistic sensitivity analyses.Results: The ZOL-FO group gained 1.64 QALYs at $87,746.35, while the PLB-FO group gained 1.23 QALYs at $11,947.81. The ICER for ZOL-FO versus PLB-FO was $185,353.28 per QALY gained. The parameters exerting an important impact on the model results were the price of zolbetuximab, body surface area, and progression-free survival utility. At a willingness-to-pay threshold of $38,201/QALY, ZOL-FO had a 0% probability of cost-effectiveness compared with PLB-FO.Conclusion: From the perspective of the Chinese healthcare system, ZOL-FO is unlikely to be cost-effective as the first-line treatment option for CLDN18.2-positive, HER2-negative advanced G/GEJ adenocarcinoma.

【 授权许可】

Unknown   
Copyright © 2023 Huang, You, Wu and Chen.