ArticleMedicine2026
Cost-effectiveness of pembrolizumab plus chemoradiotherapy versus placebo plus chemoradiotherapy for high-risk locally advanced cervical cancer in Saudi Arabia: A model-based economic evaluation.
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.
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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.
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9 authors.
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Abstract
backgroundAdding pembrolizumab to standard concurrent chemoradiotherapy (CCRT) has shown substantial survival benefits in newly diagnosed, high-risk locally advanced cervical cancer (LACC), but its economic value in Saudi Arabia has not been established. This study assessed the cost-effectiveness of pembrolizumab plus CCRT versus placebo plus CCRT as first-line treatment for high-risk LACC from the perspective of the Saudi Arabian healthcare payer.
methodsA partitioned survival analysis model was developed to project lifetime costs and quality-adjusted life-years (QALYs) for a hypothetical cohort of women with high-risk LACC in the Saudi public healthcare sector, using resource use patterns consistent with major tertiary care and specialized cancer centers. Clinical efficacy data were obtained from the KEYNOTE-A18 trial. Costs were sourced from official Saudi price lists, local hospital data, and a formal Structured Expert Elicitation process, and were reported in 2025 United States dollars. Health state utilities were derived from the literature. The primary outcome was the incremental cost-effectiveness ratio. Future costs and QALYs were discounted at an annual rate of 3%. Comprehensive deterministic and probabilistic sensitivity analyses were conducted to assess uncertainty.
resultsAdding pembrolizumab to CCRT resulted in an incremental gain of 3.51 life-years and 2.93 QALYs at an additional cost of $242,043 compared with placebo plus CCRT. At its current list price, the regimen yielded an incremental cost-effectiveness ratio of $82,626 per QALY. At a willingness-to-pay threshold of $90,000 per QALY, the probability of the pembrolizumab regimen being cost-effective was 67%.
conclusionPembrolizumab in combination with CCRT provides substantial clinical benefits in patients with high-risk LACC in Saudi Arabia. At the current price, this regimen is likely to be considered cost-effective. The analysis provides a strong, evidence-based rationale for significant price negotiations to ensure that the regimen delivers value to the Saudi healthcare system.
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