ArticleFrontiers in pharmacology2026
Disitamab vedotin plus toripalimab as a first-line treatment for HER2-expressing advanced urothelial cancer: a cost-effectiveness analysis from China based on the RC48-C016 trial.
Article in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The phase III RC48-C016 trial demonstrated that disitamab vedotin plus toripalimab (DV + T) provides significant survival benefits compared to chemotherapy in patients with HER2-expressing advanced urothelial cancer (UC), along with a favorable safety profile. However, its cost-effectiveness has not yet been evaluated. This study aims to evaluate the cost-effectiveness of DV + T versus chemotherapy as first-line treatment for HER2-expressing advanced UC from the perspective of the Chinese healthcare system. Methods: A partitioned survival model with a 15-year time horizon was developed to evaluate the cost-effectiveness of DV + T compared to chemotherapy. Outcomes included total cost, quality-adjusted life year (QALY), and the incremental cost-effectiveness ratio (ICER). Model uncertainty was examined through one-way and probabilistic sensitivity analyses. Results: DV + T yielded 2.44 QALYs at a total cost of $98,514.95, while chemotherapy yielded 1.43 QALYs at a cost of $28,300.87. The ICER was $69,575.31 per QALY. In China, at a willingness-to-pay (WTP) threshold of $20,167.02 per QALY, DV + T has a 0% probability of being cost-effective as a first-line treatment for HER2-expressing advanced UC compared to chemotherapy. Subgroup analysis suggested that the ICER of DV + T versus chemotherapy tended to be substantially lower in patients ineligible to receive cisplatin ($61,264.33 per QALY) than in those eligible for cisplatin-based chemotherapy ($245,983.12 per QALY). Conclusion: From the perspective of the Chinese healthcare system, DV + T is not cost-effective as first-line treatment for HER2-expressing advanced UC compared to chemotherapy.
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