Cost-effectiveness analysis of sugemalimab combined with chemotherapy as first-line treatment for advanced gastric cancer

ObjectiveBased on findings from the GEMSTONE-303 trial, the sugemalimab plus capecitabine and oxaliplatin regimen showed superior clinical efficacy compared to chemotherapy alone in advanced gastric cancer patients. This economic evaluation study assesses the cost-effectiveness of sugemalimab combin...

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Main Authors: Lian Tang, LongXun Zhu, ShaoQing Zhan, Yong Chen, Pan-Feng Feng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1620663/full
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author Lian Tang
LongXun Zhu
LongXun Zhu
ShaoQing Zhan
Yong Chen
Pan-Feng Feng
Pan-Feng Feng
Pan-Feng Feng
author_facet Lian Tang
LongXun Zhu
LongXun Zhu
ShaoQing Zhan
Yong Chen
Pan-Feng Feng
Pan-Feng Feng
Pan-Feng Feng
author_sort Lian Tang
collection DOAJ
description ObjectiveBased on findings from the GEMSTONE-303 trial, the sugemalimab plus capecitabine and oxaliplatin regimen showed superior clinical efficacy compared to chemotherapy alone in advanced gastric cancer patients. This economic evaluation study assesses the cost-effectiveness of sugemalimab combination therapy within China’s healthcare system framework.MethodsA partitioned survival model was constructed based on data from the GEMSTONE-303 study, with a cycle length of 3 weeks. The model simulated patients’ direct medical costs and quality-adjusted life years (QALYs) over a 10-year period. The incremental cost-effectiveness ratio (ICER) was used as the evaluation metric, comparing the ICER against the willingness-to-pay (WTP) threshold (3 times China’s per capita GDP in 2024, 287,391 CNY/QALY). One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to assess the robustness of the results.ResultsThe base-case analysis showed that the sugemalimab regimen provided greater health benefits compared to the placebo group (1.36 QALYs vs. 1.24 QALYs) but incurred significantly higher costs (271,041.24 CNY vs. 44,174.69 CNY), yielding an ICER of 1,890,554.58 CNY/QALY. One-way sensitivity analysis indicated that the utility values for the progressive disease (PD) state, progression-free survival (PFS) state, and the cost of sugemalimab had the most substantial impact on the ICER. Probabilistic sensitivity analysis demonstrated stable results, with a 0% probability that the sugemalimab combination regimen was cost-effective.ConclusionUnder the current economic conditions in China, sugemalimab combined with chemotherapy as a first-line treatment for advanced gastric cancer is not cost-effective.
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spelling doaj-art-4ce489f15401453e8b87eac6b919ee0f2025-08-20T03:09:34ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.16206631620663Cost-effectiveness analysis of sugemalimab combined with chemotherapy as first-line treatment for advanced gastric cancerLian Tang0LongXun Zhu1LongXun Zhu2ShaoQing Zhan3Yong Chen4Pan-Feng Feng5Pan-Feng Feng6Pan-Feng Feng7Department of Pharmacy, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong City, Nantong, ChinaDepartment of Pharmacy, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong City, Nantong, ChinaNantong Key Laboratory of Innovative Research on Rheumatology and Immunology, Nantong, ChinaDepartment of Pharmacy, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong City, Nantong, ChinaDepartment of Pharmacy, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong City, Nantong, ChinaDepartment of Pharmacy, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong City, Nantong, ChinaNantong Key Laboratory of Innovative Research on Rheumatology and Immunology, Nantong, ChinaNantong Clinical Medical College of Kangda College of Nanjing Medical University, Nantong, ChinaObjectiveBased on findings from the GEMSTONE-303 trial, the sugemalimab plus capecitabine and oxaliplatin regimen showed superior clinical efficacy compared to chemotherapy alone in advanced gastric cancer patients. This economic evaluation study assesses the cost-effectiveness of sugemalimab combination therapy within China’s healthcare system framework.MethodsA partitioned survival model was constructed based on data from the GEMSTONE-303 study, with a cycle length of 3 weeks. The model simulated patients’ direct medical costs and quality-adjusted life years (QALYs) over a 10-year period. The incremental cost-effectiveness ratio (ICER) was used as the evaluation metric, comparing the ICER against the willingness-to-pay (WTP) threshold (3 times China’s per capita GDP in 2024, 287,391 CNY/QALY). One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to assess the robustness of the results.ResultsThe base-case analysis showed that the sugemalimab regimen provided greater health benefits compared to the placebo group (1.36 QALYs vs. 1.24 QALYs) but incurred significantly higher costs (271,041.24 CNY vs. 44,174.69 CNY), yielding an ICER of 1,890,554.58 CNY/QALY. One-way sensitivity analysis indicated that the utility values for the progressive disease (PD) state, progression-free survival (PFS) state, and the cost of sugemalimab had the most substantial impact on the ICER. Probabilistic sensitivity analysis demonstrated stable results, with a 0% probability that the sugemalimab combination regimen was cost-effective.ConclusionUnder the current economic conditions in China, sugemalimab combined with chemotherapy as a first-line treatment for advanced gastric cancer is not cost-effective.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1620663/fullsugemalimabfirst-line treatmentadvanced gastric cancerpartitioned survival modelcost-effectiveness analysis
spellingShingle Lian Tang
LongXun Zhu
LongXun Zhu
ShaoQing Zhan
Yong Chen
Pan-Feng Feng
Pan-Feng Feng
Pan-Feng Feng
Cost-effectiveness analysis of sugemalimab combined with chemotherapy as first-line treatment for advanced gastric cancer
Frontiers in Public Health
sugemalimab
first-line treatment
advanced gastric cancer
partitioned survival model
cost-effectiveness analysis
title Cost-effectiveness analysis of sugemalimab combined with chemotherapy as first-line treatment for advanced gastric cancer
title_full Cost-effectiveness analysis of sugemalimab combined with chemotherapy as first-line treatment for advanced gastric cancer
title_fullStr Cost-effectiveness analysis of sugemalimab combined with chemotherapy as first-line treatment for advanced gastric cancer
title_full_unstemmed Cost-effectiveness analysis of sugemalimab combined with chemotherapy as first-line treatment for advanced gastric cancer
title_short Cost-effectiveness analysis of sugemalimab combined with chemotherapy as first-line treatment for advanced gastric cancer
title_sort cost effectiveness analysis of sugemalimab combined with chemotherapy as first line treatment for advanced gastric cancer
topic sugemalimab
first-line treatment
advanced gastric cancer
partitioned survival model
cost-effectiveness analysis
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1620663/full
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