Summary
This health economic analysis, using data from the KEYNOTE-826 trial, evaluated whether pembrolizumab in combination with chemotherapy and bevacizumab represents a cost-effective first-line treatment for advanced cervical cancer within the Chinese healthcare system. The combination therapy yielded an additional 1.18 QALYs over five years but at an ICER of US$114,275.67 per QALY—exceeding China's willingness-to-pay threshold. However, the analysis identified a patient subgroup (PD-L1 CPS ≥10) where cost-effectiveness could be improved through pembrolizumab price adjustment.
Regional applicability
The findings may be broadly relevant to NHS decision-making on pembrolizumab access for cervical cancer, though cost-effectiveness thresholds and healthcare system structures differ between China and the UK. UK applicability would depend on whether comparable ICER thresholds and patient stratification criteria are adopted by NICE or other UK health technology assessment bodies.
Key measures
Quality-adjusted life years (QALYs), incremental cost-effectiveness ratio (ICER) in US$ per QALY, treatment costs (US$), programmed death-ligand 1 combined positive score (PD-L1 CPS)
Outcomes reported
The study evaluated the cost-effectiveness of pembrolizumab combined with chemotherapy and bevacizumab versus standard chemotherapy alone for persistent, recurrent, or metastatic cervical cancer over a five-year horizon. Key outcomes measured were quality-adjusted life years (QALYs) gained, incremental costs, and incremental cost-effectiveness ratios (ICERs) relative to China's willingness-to-pay threshold.
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