ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1556304
This article is part of the Research TopicHealth Economic Evaluation in Cancer Prevention and ControlView all 4 articles
Cost-effectiveness analysis of cabozantinib plus atezolizumab for advanced hepatocellular carcinoma
Provisionally accepted
- 1Department of Pharmacy, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- 2Department of Pharmacy, Zunyi Bozhou District People's Hospital, Zunyi, China
- 3Sinopharm Group Tongjitang (Guizhou) Pharmaceutical Co., Guiyang, China
- 4Guangxi Shenli Pharmaceutical Co., Guangxi, China
- 5School of Nursing, Zunyi Medical University, Zunyi, China
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Background: Cabozantinib combined with atezolizumab has been shown to prolong progression-free survival in first-line treatment of advanced hepatocellular carcinoma (HCC). However, the cost-effectiveness of this regimen remains unknown. This study aimed to evaluate the cost-effectiveness of cabozantinib plus atezolizumab compared with sorafenib for first-line treatment of advanced HCC from the perspectives of the Chinese health system and the US payers. Methods: A partitioned survival model was constructed based on a phase III randomized clinical trial (COSMIC-312) to compare the health benefits and economic outcomes of cabozantinib plus atezolizumab versus sorafenib for the treatment of hepatocellular carcinoma. Costs and utilities were This is a provisional file, not the final typeset article obtained from published literature. Data recorded included quality-adjusted life years (QALYs), life years (LYs), and incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were conducted to test the robustness of the results. Subgroup analyses were also performed. Results: From the perspectives of the US payers and the Chinese health system, the base-case ICER values for cabozantinib plus atezolizumab compared to sorafenib were $-2,731,994.74/QALY and $- 2,225,520.14/QALY, respectively. Sorafenib achieved an absolute dominance in terms of cost-effectiveness, offering greater benefits at a lower cost. The models were most sensitive to the utility values for progression-free survival and overall survival. Subgroup analyses also demonstrated that cabozantinib plus atezolizumab was unlikely to be cost-effective as a first-line treatment for advanced HCC. Conclusion: Cabozantinib plus atezolizumab was not a cost-effective treatment option for HCC when compared to sorafenib from both the Chinese healthcare system and the US payer perspectives.
Keywords: cost-effectiveness analysis, Advanced hepatocellular carcinoma, Cabozantinib, atezolizumab, Sorafenib
Received: 06 Jan 2025; Accepted: 30 Sep 2025.
Copyright: © 2025 Zhu, He, Cao, Li, Cai, Bai, Xia and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Tongxia Xia, xtx0925@163.com
Yu-He Wang, wangyh@zmu.edu.cn
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.