Cost-effectiveness analysis of durvalumab with chemotherapy and maintenance durvalumab with or without olaparib for advanced endometrial cancer
Abstract This study evaluates the cost-effectiveness of adding durvalumab to chemotherapy, with subsequent maintenance either with olaparib (DOCT) or without olaparib (DCT), versus chemotherapy alone (CT) as a first-line treatment for advanced endometrial cancer (EC) in the United States, stratified...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-01-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-86021-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832585830547324928 |
|---|---|
| author | Jiahao Zhang Jianying Lei Caicong You Wu Fu Bin Zheng Hongfu Cai Maobai Liu Na Li |
| author_facet | Jiahao Zhang Jianying Lei Caicong You Wu Fu Bin Zheng Hongfu Cai Maobai Liu Na Li |
| author_sort | Jiahao Zhang |
| collection | DOAJ |
| description | Abstract This study evaluates the cost-effectiveness of adding durvalumab to chemotherapy, with subsequent maintenance either with olaparib (DOCT) or without olaparib (DCT), versus chemotherapy alone (CT) as a first-line treatment for advanced endometrial cancer (EC) in the United States, stratified by mismatch repair deficiency (dMMR) and proficiency (pMMR). A Markov model based on DUO-E Phase III trial data simulated disease progression and outcomes. Total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICER) were evaluated. Sensitivity analysis assessed model robustness. For dMMR EC, costs (QALYs) were $1,204,763.33 (5.49), $590,732.13 (4.61), and $1,495,528.15 (3.68) for DOCT, DCT, and CT, respectively, with ICER of $584,140.94/QALYs (DOCT vs. CT) and $476,946.43/QALYs (DCT vs. CT). For pMMR EC, costs (QALYs) were $421,126.70 (3.00), $400,470.92 (2.45), and $133,424.52 (1.69), with ICER of $219,601.20/QALYs (DOCT vs. CT) and $351,777.86/QALYs (DCT vs. CT). In the overall population, costs (QALYs) were $607,921.80 (3.89), $417,637.19 (2.82), and $141,594.38 (2.16), with ICER of $269,195.01/QALYs (DOCT vs. CT) and $416,098.68/QALYs (DCT vs. CT). From a U.S. payer perspective, DOCT and DCT regimens are not cost-effective compared to CT for advanced or recurrent EC, including dMMR and pMMR subgroups, at a $150,000/QALY threshold. |
| format | Article |
| id | doaj-art-1e8169a60176402695e9f4e51ac10825 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-1e8169a60176402695e9f4e51ac108252025-01-26T12:26:14ZengNature PortfolioScientific Reports2045-23222025-01-0115111010.1038/s41598-025-86021-yCost-effectiveness analysis of durvalumab with chemotherapy and maintenance durvalumab with or without olaparib for advanced endometrial cancerJiahao Zhang0Jianying Lei1Caicong You2Wu Fu3Bin Zheng4Hongfu Cai5Maobai Liu6Na Li7Department of Pharmacy, Fujian Medical University Union HospitalDepartment of Pharmacy, Fujian Medical University Union HospitalDepartment of Pharmacy, Fujian Medical University Union HospitalDepartment of Pharmacy, Fujian Medical University Union HospitalDepartment of Pharmacy, Fujian Medical University Union HospitalDepartment of Pharmacy, Fujian Medical University Union HospitalDepartment of Pharmacy, Fujian Medical University Union HospitalDepartment of Pharmacy, Fujian Medical University Union HospitalAbstract This study evaluates the cost-effectiveness of adding durvalumab to chemotherapy, with subsequent maintenance either with olaparib (DOCT) or without olaparib (DCT), versus chemotherapy alone (CT) as a first-line treatment for advanced endometrial cancer (EC) in the United States, stratified by mismatch repair deficiency (dMMR) and proficiency (pMMR). A Markov model based on DUO-E Phase III trial data simulated disease progression and outcomes. Total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICER) were evaluated. Sensitivity analysis assessed model robustness. For dMMR EC, costs (QALYs) were $1,204,763.33 (5.49), $590,732.13 (4.61), and $1,495,528.15 (3.68) for DOCT, DCT, and CT, respectively, with ICER of $584,140.94/QALYs (DOCT vs. CT) and $476,946.43/QALYs (DCT vs. CT). For pMMR EC, costs (QALYs) were $421,126.70 (3.00), $400,470.92 (2.45), and $133,424.52 (1.69), with ICER of $219,601.20/QALYs (DOCT vs. CT) and $351,777.86/QALYs (DCT vs. CT). In the overall population, costs (QALYs) were $607,921.80 (3.89), $417,637.19 (2.82), and $141,594.38 (2.16), with ICER of $269,195.01/QALYs (DOCT vs. CT) and $416,098.68/QALYs (DCT vs. CT). From a U.S. payer perspective, DOCT and DCT regimens are not cost-effective compared to CT for advanced or recurrent EC, including dMMR and pMMR subgroups, at a $150,000/QALY threshold.https://doi.org/10.1038/s41598-025-86021-yDurvalumabOlaparibAdvanced endometrial cancerCost-effectiveness |
| spellingShingle | Jiahao Zhang Jianying Lei Caicong You Wu Fu Bin Zheng Hongfu Cai Maobai Liu Na Li Cost-effectiveness analysis of durvalumab with chemotherapy and maintenance durvalumab with or without olaparib for advanced endometrial cancer Scientific Reports Durvalumab Olaparib Advanced endometrial cancer Cost-effectiveness |
| title | Cost-effectiveness analysis of durvalumab with chemotherapy and maintenance durvalumab with or without olaparib for advanced endometrial cancer |
| title_full | Cost-effectiveness analysis of durvalumab with chemotherapy and maintenance durvalumab with or without olaparib for advanced endometrial cancer |
| title_fullStr | Cost-effectiveness analysis of durvalumab with chemotherapy and maintenance durvalumab with or without olaparib for advanced endometrial cancer |
| title_full_unstemmed | Cost-effectiveness analysis of durvalumab with chemotherapy and maintenance durvalumab with or without olaparib for advanced endometrial cancer |
| title_short | Cost-effectiveness analysis of durvalumab with chemotherapy and maintenance durvalumab with or without olaparib for advanced endometrial cancer |
| title_sort | cost effectiveness analysis of durvalumab with chemotherapy and maintenance durvalumab with or without olaparib for advanced endometrial cancer |
| topic | Durvalumab Olaparib Advanced endometrial cancer Cost-effectiveness |
| url | https://doi.org/10.1038/s41598-025-86021-y |
| work_keys_str_mv | AT jiahaozhang costeffectivenessanalysisofdurvalumabwithchemotherapyandmaintenancedurvalumabwithorwithoutolaparibforadvancedendometrialcancer AT jianyinglei costeffectivenessanalysisofdurvalumabwithchemotherapyandmaintenancedurvalumabwithorwithoutolaparibforadvancedendometrialcancer AT caicongyou costeffectivenessanalysisofdurvalumabwithchemotherapyandmaintenancedurvalumabwithorwithoutolaparibforadvancedendometrialcancer AT wufu costeffectivenessanalysisofdurvalumabwithchemotherapyandmaintenancedurvalumabwithorwithoutolaparibforadvancedendometrialcancer AT binzheng costeffectivenessanalysisofdurvalumabwithchemotherapyandmaintenancedurvalumabwithorwithoutolaparibforadvancedendometrialcancer AT hongfucai costeffectivenessanalysisofdurvalumabwithchemotherapyandmaintenancedurvalumabwithorwithoutolaparibforadvancedendometrialcancer AT maobailiu costeffectivenessanalysisofdurvalumabwithchemotherapyandmaintenancedurvalumabwithorwithoutolaparibforadvancedendometrialcancer AT nali costeffectivenessanalysisofdurvalumabwithchemotherapyandmaintenancedurvalumabwithorwithoutolaparibforadvancedendometrialcancer |