AUTHOR=Zheng Zhiwei , Yang Liu , Xu Siqi , Zhu Huide , Cai Hongfu 

TITLE=Cost-effectiveness analysis of lenvatinib plus pembrolizumab compared with chemotherapy for patients with previously treated mismatch repair proficient advanced endometrial cancer in China

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.944931

DOI=10.3389/fphar.2022.944931

ISSN=1663-9812

ABSTRACT=Aims: This study aimed to evaluate the cost effectiveness of lenvatinib plus pembrolizumab (LP) compared with chemotherapy for patients with previously treated mismatch repair proficient advanced endometrial cancer in China.
Methods: A lifetime of partitioned survival Markov model was used to evaluate the patient’s total lifetime, total costs, quality adjusted life years (QALYs), and incremental cost effectiveness ratio (ICER) across a 10-year time horizon in the study 309–KEYNOTE-775 clinical trial. Direct costs and utility values were gathered from available literature. The willingness to pay (WTP) was defined at $37663.26 per QALY. Sensitivity analyses were carried out to determine the model's uncertainty.
Results: According to the baseline analysis, the LP group gained 4.02 total life years and 3.13 QALYs for $93496.69, whereas the chemotherapy group gained 2.86 total life years and 2.24 QALYs for $30578.04. LP versus chemotherapy resulted in an incremental cost of $62918.65, with an ICER of $70962.09/QALY, which was higher than China's WTP threshold ($37663.26/QALY). The sensitivity analysis revealed that the ICERs were most sensitive to the cost of pembrolizumab and the cycle of LP administered. However, changing the range of those parameters has no significant effect on the results of the model.
Conclusion: The result of our present analysis suggests that LP treatment is not cost-effective for patients with previously treated mismatch repair proficient advanced endometrial cancer. However, LP treatment may be a cost-effective treatment option if the price is reduced.