ArticleWorld journal of urology2025
Updated cost-effectiveness analysis of first-line novel therapies in locally advanced or metastatic urothelial carcinoma across the UK, US, and China.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Cost-effectiveness analysis of Enfortumab vedotin and pembrolizumab for advanced urothelial carcinoma.Medicine · 2026Article
- Oncologic outcome and safety profile of first-line enfortumab vedotin plus pembrolizumab vs. conventional chemotherapy in advanced urothelial cancer.Exploration of targeted anti-tumor therapy · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent clinical trials (CheckMate 901 and EV-302) have shown that nivolumab plus gemcitabine-cisplatin (N + GC) and enfortumab vedotin plus pembrolizumab (EV + P) significantly improve survival in locally advanced or metastatic urothelial carcinoma (la/mUC). Updated follow-up results from the EV-302 study were presented at the ASCO GU 2025 conference, but the economic feasibility of these therapies remains unclear. This study aims to access the cost-effectiveness of N + GC and EV + P compared to chemotherapy in la/mUC across the US, UK, and China using updated follow-up data from clinical trials.
methodsThis study employed a Markov model included three health states to evaluate health outcomes and costs. Each model cycle spanned 3 weeks with 2 years, 5 years, 10 years. Patients were divided into two subgroups according to cisplatin eligibility. The outcomes were the costs, Quality Adjusted Life Years (QALYs), and Incremental cost-effectiveness ratios (ICERs).
resultsFor cisplatin-ineligible patients, the 10-year ICERs for EV + P were £136,919/QALY in the UK, $751,897/QALY in the US, and ¥1,158,228/QALY in China. For cisplatin-eligible patients, the 10-year ICERs were £125,441/QALY in the UK, $784,553/QALY in the US, and ¥1,096,445/QALY in China. N + GC demonstrated better cost-effectiveness, with 10-year ICERs of £71,202/QALY in the UK, $183,062/QALY in the US, and ¥259,844/QALY in China. Substantial price reductions were required for both therapies to meet willingness-to-pay thresholds.
conclusionsWhile EV + P offered significant survival benefits for la/mUC patients as the first-line therapy, its current pricing makes it economically unfeasible in most settings. N + GC was more cost-effective for cisplatin-eligible patients. Policymakers should consider innovative pricing strategies to ensure equitable access to treatments.
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