ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1644176
This article is part of the Research TopicAdvancing Health Technology Assessment and Patient-Reported Outcomes: Innovations and Implications for Health Economics and Outcomes ResearchView all 3 articles
Cost-Effectiveness Analysis of Cadonilimab Plus Chemotherapy as a First-Line Treatment Option in HER-2-negative Advanced Gastric Cancer：
Provisionally accepted
- 1Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
- 2Department of Acupuncture and Rehabilitation , Shantou Hospital of Traditional Chinese Medicine, Shantou, China
- 3Cancer Hospital of Shantou University Medical College, Shantou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective:This 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. Methods:A 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 ten 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. Results:The 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. Conclusion:The 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.
Keywords: Advanced gastric cancer, Cadonilimab, chemotherapy, cost-effectiveness analysis, HER-2-negative
Received: 10 Jun 2025; Accepted: 09 Jul 2025.
Copyright: © 2025 Zhang, Yang and Zheng. 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: Zhiwei Zheng, Cancer Hospital of Shantou University Medical College, Shantou, China
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.