Cost-effectiveness of nivolumab plus chemotherapy for advanced gastric/gastroesophageal junction/esophageal adenocarcinoma in the United States

Abstract

Nivolumab, in combination with chemotherapy, significantly improves survival in patients with gastric/gastroesophageal junction (G/GEJ)/esophageal adenocarcinoma. The study evaluated the cost-effectiveness of nivolumab plus chemotherapy for the treatment of G/GEJ/esophageal adenocarcinoma. A Markov model was developed from the perspective of United States healthcare payers. We estimated costs and summarized effectiveness in terms of quality-adjusted life-years (QALYs). One-way and probabilistic sensitivity analyses were conducted to assess the impact of uncertainties on the cost-effectiveness results. The incremental cost-effectiveness ratio for nivolumab plus chemotherapy (149,636.97,1.24QALYs)comparedtochemotherapyalone(149,636.97,1.24QALYs)comparedtochemotherapyalone(13,941.06, 0.75 QALYs) is $135,695.91, with a difference of 0.49 QALYs. Evidence suggests that nivolumab plus chemotherapy for the first-line treatment of locally advanced or metastatic G/GEJ/esophageal adenocarcinoma may not represent a cost-effective option within the United States healthcare system.

Keywords

Cost-effectiveness / Nivolumab / Metastatic gastric/gastroesophageal junction/esophageal adenocarcinoma / Markov model

Funding

The study was self-funded by the authors and did not rely on external funding sources.

Conflict of interest

The authors declare that there is no conflict of interest.

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