ArticleFrontiers in public health2025
Nivolumab plus ipilimumab versus lenvatinib or sorafenib for US and Chinese patients with unresectable hepatocellular carcinoma: a cost-effectiveness analysis.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07493668 (A Phase 2, Multicenter, Randomized, Open-label Study Comparing Fostrox + Lenvatinib vs. Lenvatinib in Patients With Locally Advanced or Unresectable Advanced Hepatocellular Carcinoma), which is not on this map. Cited by 1 paper.
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.
A Phase 2, Multicenter, Randomized, Open-label Study Comparing Fostrox + Lenvatinib vs. Lenvatinib in Patients With Locally Advanced or Unresectable Advanced Hepatocellular Carcinoma (HCC) Who Have Received First-line Combination Immunotherapy
Who cites it
1 citing paper in PubMed.
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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The CheckMate 9DW trial showed that nivolumab plus ipilimumab (NIVO + IPI) improves overall survival over lenvatinib or sorafenib (LEN/SOR) in patients with unresectable hepatocellular carcinoma (uHCC). We evaluated the cost-effectiveness of NIVO + IPI versus LEN/SOR from payer perspectives in the United States (US) and China, explicitly aiming to inform reimbursement and price-negotiation decisions in each setting. Methods: Based on the overall and subgroup data from the CheckMate 9DW trial, we developed a partitioned survival model to compare the clinical outcomes of NIVO + IPI versus LEN/SOR. Costs included drugs, administration, monitoring, adverse event management, and follow-up care in both the US and China. A lifetime horizon (1-month cycles) and 2024 US dollars were applied. The primary outcome was the incremental cost-effectiveness ratio (ICER), expressed as cost per quality-adjusted life year (QALY) gained. Willingness-to-pay (WTP) thresholds were $150,000/QALY (US) and $39,933.67/QALY (China). Model uncertainty was assessed through one-way and probabilistic sensitivity analyses. Results: In the US, the NIVO + IPI regimen generated an incremental gain of 0.68 QALYs at an additional cost of $86,403.43, resulting in an ICER of $127,063.87 per QALY. In the China subgroup, NIVO + IPI yielded an incremental gain of 0.94 QALYs with an incremental cost of $35,358.47, corresponding to an ICER of $37,615.40 per QALY. Sensitivity analyses indicated that the ICER was mostly influenced by variations in the discount rate and drug prices. Probabilistic sensitivity analysis demonstrated that the probability of NIVO + IPI being cost-effective exceeded 50% at the respective WTP thresholds in both the United States and China. Conclusion: This study suggests that NIVO + IPI is cost-effective in both the United States and China at current price levels.
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