Cost-effectiveness analysis of cadonilimab plus chemotherapy as a first-line treatment option in HER-2-negative advanced gastric cancer

ObjectiveThis study aims to evaluate the cost-effectiveness of using cadonilimab plus chemotherapy compared to chemotherapy in HER-2-negative advanced gastric cancer from the perspective of the Chinese healthcare system.MethodsA cost-effectiveness analysis was conducted utilizing a partitioned survi...

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Main Authors: Longfeng Zhang, Qingsheng Yang, Zhiwei Zheng
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.2025.1644176/full
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author Longfeng Zhang
Qingsheng Yang
Zhiwei Zheng
author_facet Longfeng Zhang
Qingsheng Yang
Zhiwei Zheng
author_sort Longfeng Zhang
collection DOAJ
description ObjectiveThis study aims to evaluate the cost-effectiveness of using cadonilimab plus chemotherapy compared to chemotherapy in HER-2-negative advanced gastric cancer from the perspective of the Chinese healthcare system.MethodsA cost-effectiveness analysis was conducted utilizing a partitioned survival model to simulate the expected costs and outcomes associated with the treatment of patients with cadonilimab in combination with chemotherapy versus chemotherapy over a 10 years lifetime horizon. Cost data were sourced from published literature and national databases. Data on treatment efficacy, adverse events, and transition probabilities were derived from the phase 3 COMPASSION-15 trial. The WTP threshold in this study was established at 40,343.68 USD per QALY. Sensitivity analyses were performed to evaluate the robustness of the results and assess the impact of variations in key parameters on the cost-effectiveness outcomes.ResultsThe base case analysis revealed that in all population of randomized patients, treatment with cadonilimab resulted in an incremental gain of 1.08 QALYs compared to chemotherapy, at an incremental cost of 58,862.61 USD. The ICER for this cohort was calculated to be 54,502.42 USD per QALY. In the subgroup of patients with a PD-L1 CPS ≥ 5, patients treated with cadonilimab experienced a greater increase in 1.33 QALYs compared to chemotherapy, at an incremental cost of 35,661.87 USD. The ICER for this subgroup was 26,813.44 USD per QALY. Sensitivity analyses conducted demonstrated the robustness of the results to variations in model inputs and assumptions. Moreover, the probabilistic sensitivity analysis indicated that cadonilimab in combination with chemotherapy had a 4.70 and 93.90% probabilities of being considered cost-effective at a WTP threshold of 40,343.68 USD per QALY for the all randomized patient group and the subgroup of patients with a PD-L1 CPS ≥ 5, respectively.ConclusionThe addition of cadonilimab to standard chemotherapy for first line treatment of HER-2-negative advanced gastric cancer may not be considered a cost-effective option compared to chemotherapy alone. However, for the subgroup of patients with PD-L1CPS ≥ 5, the ICER was 26,813.44 USD per QALY, indicating that this treatment approach could potentially be deemed cost-effective in China.
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spelling doaj-art-8b0c26c8acdb4baf8d65433fae74140f2025-08-20T03:13:27ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.16441761644176Cost-effectiveness analysis of cadonilimab plus chemotherapy as a first-line treatment option in HER-2-negative advanced gastric cancerLongfeng Zhang0Qingsheng Yang1Zhiwei Zheng2Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, ChinaDepartment of Acupuncture and Rehabilitation, Shantou Hospital of Traditional Chinese Medicine, Shantou, ChinaDepartment of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, ChinaObjectiveThis study aims to evaluate the cost-effectiveness of using cadonilimab plus chemotherapy compared to chemotherapy in HER-2-negative advanced gastric cancer from the perspective of the Chinese healthcare system.MethodsA cost-effectiveness analysis was conducted utilizing a partitioned survival model to simulate the expected costs and outcomes associated with the treatment of patients with cadonilimab in combination with chemotherapy versus chemotherapy over a 10 years lifetime horizon. Cost data were sourced from published literature and national databases. Data on treatment efficacy, adverse events, and transition probabilities were derived from the phase 3 COMPASSION-15 trial. The WTP threshold in this study was established at 40,343.68 USD per QALY. Sensitivity analyses were performed to evaluate the robustness of the results and assess the impact of variations in key parameters on the cost-effectiveness outcomes.ResultsThe base case analysis revealed that in all population of randomized patients, treatment with cadonilimab resulted in an incremental gain of 1.08 QALYs compared to chemotherapy, at an incremental cost of 58,862.61 USD. The ICER for this cohort was calculated to be 54,502.42 USD per QALY. In the subgroup of patients with a PD-L1 CPS ≥ 5, patients treated with cadonilimab experienced a greater increase in 1.33 QALYs compared to chemotherapy, at an incremental cost of 35,661.87 USD. The ICER for this subgroup was 26,813.44 USD per QALY. Sensitivity analyses conducted demonstrated the robustness of the results to variations in model inputs and assumptions. Moreover, the probabilistic sensitivity analysis indicated that cadonilimab in combination with chemotherapy had a 4.70 and 93.90% probabilities of being considered cost-effective at a WTP threshold of 40,343.68 USD per QALY for the all randomized patient group and the subgroup of patients with a PD-L1 CPS ≥ 5, respectively.ConclusionThe addition of cadonilimab to standard chemotherapy for first line treatment of HER-2-negative advanced gastric cancer may not be considered a cost-effective option compared to chemotherapy alone. However, for the subgroup of patients with PD-L1CPS ≥ 5, the ICER was 26,813.44 USD per QALY, indicating that this treatment approach could potentially be deemed cost-effective in China.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1644176/fulladvanced gastric cancercadonilimabchemotherapycost-effectiveness analysisHER-2-negative
spellingShingle Longfeng Zhang
Qingsheng Yang
Zhiwei Zheng
Cost-effectiveness analysis of cadonilimab plus chemotherapy as a first-line treatment option in HER-2-negative advanced gastric cancer
Frontiers in Public Health
advanced gastric cancer
cadonilimab
chemotherapy
cost-effectiveness analysis
HER-2-negative
title Cost-effectiveness analysis of cadonilimab plus chemotherapy as a first-line treatment option in HER-2-negative advanced gastric cancer
title_full Cost-effectiveness analysis of cadonilimab plus chemotherapy as a first-line treatment option in HER-2-negative advanced gastric cancer
title_fullStr Cost-effectiveness analysis of cadonilimab plus chemotherapy as a first-line treatment option in HER-2-negative advanced gastric cancer
title_full_unstemmed Cost-effectiveness analysis of cadonilimab plus chemotherapy as a first-line treatment option in HER-2-negative advanced gastric cancer
title_short Cost-effectiveness analysis of cadonilimab plus chemotherapy as a first-line treatment option in HER-2-negative advanced gastric cancer
title_sort cost effectiveness analysis of cadonilimab plus chemotherapy as a first line treatment option in her 2 negative advanced gastric cancer
topic advanced gastric cancer
cadonilimab
chemotherapy
cost-effectiveness analysis
HER-2-negative
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1644176/full
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