ArticleCancer medicine2025
Cost-Effectiveness of Pembrolizumab Plus Trastuzumab and Chemotherapy Versus Trastuzumab Plus Chemotherapy as First-Line Treatment of HER2-Positive Gastric or Gastroesophageal Junction Adenocarcinoma in China.
Article in Cancer medicine, 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aimed to evaluate the cost-effectiveness of pembrolizumab in combination with trastuzumab and chemotherapy (PEM + TRAS + Chemo) as a first-line treatment for patients with advanced HER2-positive gastric or gastroesophageal junction (GEJ) adenocarcinoma from the perspective of the Chinese healthcare system.
methodsClinical data from the KEYNOTE-811 trial were used to develop a partitioned survival model for HER2-positive gastric or GEJ adenocarcinoma. The model estimated quality-adjusted life years (QALYs), life years (LYs), and total lifetime costs. The primary outcome was the Incremental Cost-Effectiveness Ratio (ICER), reflecting the cost per additional QALY. Only direct medical costs were considered, with drug prices sourced from the China Drug Bidding Database and other costs and utility values derived from published literature. Uncertainty analyses were conducted to test the robustness of the model, and subgroup analyses were performed to assess cost-effectiveness in different patient populations.
resultsIn the base-case analysis, the PEM + TRAS + Chemo regimen increased LYs by 0.17 and QALYs by 0.19, at an additional cost of $9874.08, resulting in an ICER of $53,160.95/QALY, which exceeds three times the per capita GDP of China ($39,999.86). Subgroup analysis based on the patient's programmed death-ligand 1 (PD-L1) combined positive score (CPS) showed that for PD-L1 (CPS ≥ 1) patients, the ICER was $49,849.43 per QALY. Uncertainty analysis indicated that the proportion of patients receiving subsequent systemic treatment had the most significant impact on the model results.
conclusionIn China, for first-line treatment of HER2-positive advanced gastric or GEJ adenocarcinoma, the PEM + TRAS + Chemo regimen is not cost-effective when compared to the TRAS + Chemo regimen, unless the price of pembrolizumab is reduced.
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