Comparative Cost-Effectiveness Analysis of Multiple First-Line Treatments for HER2-Negative Unresectable Advanced or Recurrent Gastric Cancer in Japan.
1/5 보강
[BACKGROUND/OBJECTIVE] HER2-negative unresectable advanced or recurrent gastric cancer (GC) has a poor prognosis.
- 연구 설계 meta-analysis
APA
Morimoto K, Moriwaki K, et al. (2026). Comparative Cost-Effectiveness Analysis of Multiple First-Line Treatments for HER2-Negative Unresectable Advanced or Recurrent Gastric Cancer in Japan.. PharmacoEconomics - open. https://doi.org/10.1007/s41669-025-00634-7
MLA
Morimoto K, et al.. "Comparative Cost-Effectiveness Analysis of Multiple First-Line Treatments for HER2-Negative Unresectable Advanced or Recurrent Gastric Cancer in Japan.." PharmacoEconomics - open, 2026.
PMID
41665852
Abstract
[BACKGROUND/OBJECTIVE] HER2-negative unresectable advanced or recurrent gastric cancer (GC) has a poor prognosis. This study evaluated the comparative cost-effectiveness of multiple first-line treatment options from the Japanese healthcare payer perspective.
[METHODS] A partitioned survival model was developed to estimate the cost-effectiveness of each regimen. Hazard ratios were derived from a network meta-analysis to project long-term costs and quality-adjusted life years (QALYs) gained. Regimens included pembrolizumab plus chemotherapy (Pem + Chemo); zolbetuximab plus chemotherapy (Zolb + Chemo); nivolumab plus chemotherapy (NIVO + Chemo); 5-fluorouracil, oxaliplatin, and levofolinate (FOLFOX); capecitabine and oxaliplatin (CapeOx); S-1 and oxaliplatin (SOX), capecitabine and cisplatin (Cape + CDDP); and S-1 and cisplatin (S-1 + CDDP). Cost parameters were obtained from a Japanese medical claims database. Incremental cost-effectiveness ratios (ICERs) were calculated for each regimen. Sensitivity analyses were conducted to assess parameter uncertainty. Scenario analysis was conducted by incorporating tislelizumab, which is approved and recommended in countries outside Japan.
[RESULTS] On the basis of the base-case analysis, CapeOx, SOX, Pem + Chemo (5-FU + CDDP, CapeOx), and Zolb + CapeOx were located on the efficiency frontier. The ICER of SOX versus CapeOx was USD 85,649/QALY. Pem + Chemo versus SOX had an ICER of USD 345,103/QALY. Zolb + CapeOx versus Pem + Chemo had an ICER of USD 1,637,571/QALY. Probabilistic sensitivity analysis showed SOX had the highest probability (40.33%) of being the most cost-effective.
[CONCLUSIONS] At a willingness-to-pay threshold of USD 100,000/QALY (Japan's HTA upper reference), SOX was identified as the most cost-effective first-line treatment for HER2-negative unresectable advanced or recurrent GC in Japan.
[METHODS] A partitioned survival model was developed to estimate the cost-effectiveness of each regimen. Hazard ratios were derived from a network meta-analysis to project long-term costs and quality-adjusted life years (QALYs) gained. Regimens included pembrolizumab plus chemotherapy (Pem + Chemo); zolbetuximab plus chemotherapy (Zolb + Chemo); nivolumab plus chemotherapy (NIVO + Chemo); 5-fluorouracil, oxaliplatin, and levofolinate (FOLFOX); capecitabine and oxaliplatin (CapeOx); S-1 and oxaliplatin (SOX), capecitabine and cisplatin (Cape + CDDP); and S-1 and cisplatin (S-1 + CDDP). Cost parameters were obtained from a Japanese medical claims database. Incremental cost-effectiveness ratios (ICERs) were calculated for each regimen. Sensitivity analyses were conducted to assess parameter uncertainty. Scenario analysis was conducted by incorporating tislelizumab, which is approved and recommended in countries outside Japan.
[RESULTS] On the basis of the base-case analysis, CapeOx, SOX, Pem + Chemo (5-FU + CDDP, CapeOx), and Zolb + CapeOx were located on the efficiency frontier. The ICER of SOX versus CapeOx was USD 85,649/QALY. Pem + Chemo versus SOX had an ICER of USD 345,103/QALY. Zolb + CapeOx versus Pem + Chemo had an ICER of USD 1,637,571/QALY. Probabilistic sensitivity analysis showed SOX had the highest probability (40.33%) of being the most cost-effective.
[CONCLUSIONS] At a willingness-to-pay threshold of USD 100,000/QALY (Japan's HTA upper reference), SOX was identified as the most cost-effective first-line treatment for HER2-negative unresectable advanced or recurrent GC in Japan.