ArticleMedicine2026
Cost-effectiveness analysis of Enfortumab vedotin and pembrolizumab for advanced urothelial carcinoma.
Article in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
backgroundTo evaluate the cost-effectiveness of Enfortumab vedotin and pembrolizumab (EVP) as a new first-line treatment option for advanced urothelial carcinoma compared to standard chemotherapy (gemcitabine with cisplatin or carboplatin) from the perspective of the US healthcare payer.
methodsA partitioned survival model was used to evaluate the cost-effectiveness of EVP compared to standard chemotherapy, incorporating 3 health states: progression-free survival (PFS), progressive disease, and death. The analysis was conducted from the perspective of a US healthcare payer (Veterans Affairs, VA) using a 21-day simulation cycle over a 30-year horizon. Survival data were derived from the EV-302 trial and reconstructed using standard parametric models as well as flexible parametric models. Costs and utility values were sourced from public databases and literature. Sensitivity and scenario analyses assessed the impact of key parameters and different subgroups, with price simulations identifying the threshold price for cost-effectiveness. Total costs (in US dollars), life years, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios were used as main outcomes.
resultsIn the base-case analysis, the lifetime cost of EVP was $989,917, providing an effectiveness of 2.50 QALYs and 4.86 life years. In contrast, chemotherapy cost $166,397 with an effectiveness of 1.49 QALYs and 2.83 life years. The incremental cost-effectiveness ratio for EVP compared to chemotherapy was $814,875 per QALY, indicating it is not cost-effective at the $150,000 threshold. Sensitivity analyses highlighted that the utility for PFS and the pricing of Enfortumab vedotin (EV) significantly impacted cost-effectiveness. Probabilistic sensitivity analysis confirmed chemotherapy as the most cost-effective option across a willingness-to-pay range of $0 to $300,000. Price simulations suggested that EVP would become cost-effective compared to chemotherapy if the price of EV were reduced to $593 per 20 mg. Subgroup analysis showed that at its original price, EV was not cost-effective in any subgroup. However, reducing its price to 22 to 29% of the original made EVP economically viable for various subgroups.
conclusionsEVP is more effective than chemotherapy but not cost-effective from the perspective of the VA. To achieve cost-effectiveness, a price reduction for EV is necessary.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.