Cost-effectiveness Analysis of Cadonilimab in Combination with Chemotherapy for the First-line Treatment of Recurrent or Metastatic Cervical Cancer

OBJECTIVE  To evaluate the economics of cadonilimab in conjunction with standard chemotherapy for the treatment of recurrent or metastatic cervical cancer from the standpoint of China health system.

METHODS  Based on the COMPASSION-16 data from the clinical study, a Markov model was developed to simulate the disease progression of cervical cancer, and the time frame of the simulation study was 10 years, with 21 d as a cycle. Quality-adjusted life years(QALYs) were used to compute the incremental cost-effectiveness ratio(ICER) as the base result and the sensitivity analysis was used to confirm the model’s robustness in comparison with the willingness-to-pay threshold(WTP).

RESULTS  The baseline results analysis demonstrated that the cost of the cadonilimab group was 487111.92 yuan, which was an increase in cost of 313761.9 yuan compared with the placebo group, as well as an increase of 0.5 QALYs in the cadonilimab group, and the ICER value was 628736.84 yuan·QALY⁻¹, above the WTP threshold value of 287247 yuan·QALY⁻¹. The cost of cadonilimab and utility value were the most affecting elements on the ICER value in the sensitivity analysis. The results of the health insurance reimbursement scenario analysis showed that when the treatment plan was reimbursed at 70%, the ICER value of the cadonilimab group was 188621.05 yuan·QALY⁻¹, which was extrapolated to be economical for the cadonilimab group when the reimbursement rate was ≥54.31% and the ICER value was ≤287247 yuan·QALY⁻¹.

CONCLUSION  After cadonilimab included in the 2024 national health insurance catalog, its combination with standard chemotherapy is economical when the treatment regimen health insurance reimbursement ratio is ≥54.31% at a WTP threshold of 3 times China’s 2024 per capita gross domestic product.