Lenvatinib plus pembrolizumab in the patients with advanced previously treated endometrial cancer: A cost‐effectiveness analysis in the United States and in China

• Published in: The journal of obstetrics and gynaecology research Vol. 50; no. 5; pp. 881 - 889
• Main Authors: Liao, Xiaodong, Wu, Yajing, Lin, Dong, Gu, Dian, Luo, Shaohong, Huang, Xiaoting, Xu, Xiongwei, Weng, Xiuhua, Lin, Shen
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01.05.2024; Wiley Subscription Services, Inc
• Subjects: advanced endometrial cancer; Antibodies, Monoclonal, Humanized - administration & dosage; Antibodies, Monoclonal, Humanized - economics; Antibodies, Monoclonal, Humanized - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - economics; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy; China; Cost-Effectiveness Analysis; cost‐effectiveness; Decision making; Endometrial cancer; Endometrial Neoplasms - drug therapy; Endometrial Neoplasms - economics; Endometrium; Female; Humans; lenvatinib; Patients; Pembrolizumab; Phenylurea Compounds - administration & dosage; Phenylurea Compounds - economics; Phenylurea Compounds - therapeutic use; Quality-Adjusted Life Years; Quinolines - administration & dosage; Quinolines - economics; Quinolines - therapeutic use; Sensitivity analysis; Survival; United States; Uterine cancer; United States; China; United States > US; cost‐effectiveness; pembrolizumab; lenvatinib; advanced endometrial cancer
• ISSN: 1341-8076; 1447-0756; 1447-0756
• DOI: 10.1111/jog.15910

Purpose To investigate the cost‐effectiveness of lenvatinib plus pembrolizumab (LP) compared to chemotherapy as a second‐line treatment for advanced endometrial cancer (EC) from the United States and Chinese payers' perspective. Methods In this economic evaluation, a partitioned survival model was constructed from the perspective of the United States and Chinese payers. The survival data were derived from the clinical trial (309‐KEYNOTE‐775), while costs and utility values were sourced from databases and published literature. Total costs, quality‐adjusted life years (QALYs) and incremental cost‐effectiveness ratio (ICER) were estimated. The robustness of the model was evaluated through sensitivity analyses, and price adjustment scenario analyses was also performed. Results Base‐case analysis indicated that LP wouldn't be cost‐effective in the United States at the WTP threshold of $200 000, with improved effectiveness of 0.75 QALYs and an additional cost of $398596.81 (ICER $531392.20). While LP was cost‐effective in China, with improved effectiveness of 0.75 QALYs and an increased overall cost of $62270.44 (ICER $83016.29). Sensitivity analyses revealed that the above results were stable. The scenario analyses results indicated that LP was cost‐effective in the United States when the prices of lenvatinib and pembrolizumab were simultaneously reduced by 61.95% ($26.5361/mg for lenvatinib and $19.1532/mg for pembrolizumab). Conclusion LP isn't cost‐effective in the patients with advanced previously treated endometrial cancer in the United States, whereas it is cost‐effective in China. The evidence‐based pricing strategy provided by this study could benefit decision‐makers in making optimal decisions and clinicians in general clinical practice. More evidence about budget impact and affordability for patients is needed.