Atezolizumab plus bevacizumab is unlikely to be cost-effective compared with sorafenib for the first-line treatment of unresectable or metastatic hepatocellular carcinoma (HCC), according to a study presented at the virtual 2021 ASCO Gastrointestinal Cancers Symposium.
“The FDA approved the combination as a new first line treatment for these patients. However, because of the high cost of the new treatment there is a need to assess its value by considering both efficacy and cost, so we conducted this cost effectiveness analysis,” said Wenjun Wang, MD, Department of Hepatology and Infectious Disease, Second Affiliated Hospital of Xi’an Jiaotong University, China, lead author of the study, during his presentation.
This study aimed to evaluate the cost-effectiveness of atezolizumab plus bevacizumab compared with sorafenib for patients with unresectable or metastatic HCC from the US payer perspective.
A partitioned survival model was developed to compared health care costs and clinical outcomes of each treatment regimen over a 6-year timespan. Incremental cost-effectiveness ratio (ICER) was calculated as the ratio of the incremental cost to the incremental quality-adjusted life years (QALYs).
At the base case analysis, atezolizumab plus bevacizumab yielded an increase of 0.623 life-years, 0.484 QALYs and $158,781 per patient. The ICER was $322,500 per QALY, with 0.5% chance of being cost-effective at a willingness-to-pay (WTP) threshold of $100,000 and 4.1% chance of being cost-effective at a WTP threshold of $150,000 per QALY. In the one-way sensitivity and subgroup analyses, the ICER never dipped below $150,000 per QALY.
“In conclusion atezolizumab plus bevacizumab is unlikely to be cost-effective compared with sorafenib in first-line treatment of patients was unresectable or metastatic HCC from the US payer perspective,” Dr Wang concluded.—Janelle Bradley
Wang W, Wang J, Zhang X, et al. Atezolizumab plus bevacizumab for unresectable or metastatic hepatocellular carcinoma: A cost-effectiveness analysis. Presented at: the virtual 2021 ASCO Gastrointestinal Cancers Symposium; January 15-17, 2021. Abstract 295.