Scholarlink

Background <p>Given the rising incidence of endometrial cancer in Saudi Arabia, the integration of high-cost therapeutics, such as dostarlimab (DSR), for primary advanced or recurrent (pA/rEC) disease necessitates rigorous economic appraisal. Therefore, this study aimed to evaluate the cost-utility of first-line dostarlimab plus carboplatin-paclitaxel (DSR + CP) versus placebo plus carboplatin-paclitaxel (PBO + CP) from the perspective of the Saudi healthcare payer.</p> Methods <p>A partitioned survival model was constructed to simulate patient prognosis across three health states: progression-free disease, progressive disease, and death. The model parameters were derived from the clinical efficacy data of the RUBY trial and the local cost inputs. The primary outcome was the incremental cost-effectiveness ratio (ICER), the robustness of which was evaluated via comprehensive deterministic and probabilistic sensitivity analyses to characterize parameter uncertainty.</p> Results <p>For the overall pA/rEC population, the DSR + CP regimen yielded an incremental 1.55 quality-adjusted life-years (QALYs) at an additional cost of $144,716, resulting in an ICER of $93,244 per QALY. Cost-effectiveness was more favorable in the mismatch repair deficient (dMMR) subgroup (ICER: $82,754/QALY) than in the mismatch repair proficient (pMMR) cohort (ICER: $132,571/QALY). The ICER is the most sensitive to the acquisition cost of the DSR. At a willingness-to-pay threshold of $90,000/QALY, the probability of DSR + CP being cost-effective was 83.9% for the dMMR subgroup.</p> Conclusion <p>This economic evaluation indicates that DSR + CP constitutes a cost-effective intervention for pA/rEC within the dMMR subpopulation. These findings provide strong evidence for a tailored reimbursement policy that effectively utilizes resources by connecting clinical benefits with economic value in the management of pA/rEC.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Cost-utility of first-line dostarlimab plus carboplatin-paclitaxel compared with placebo for patients with pA/rEC: a partitioned survival analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月23日

查看全文
  • Ziyad S. Almalki,
  • Saba S. Albanna,
  • Yahia A. Hadadi,
  • Ahmed M. Alshehri,
  • Kamar Z. Jamal,
  • Saja H. Almazrou,
  • Jameilh A. Alsamiri,
  • Abdulrahman A. Alsuhibani,
  • Abdullah A. Alalwan,
  • Ahmad A. Alamer,
  • Nehad J. Ahmed,
  • Abeer A. Shhada,
  • Ghuafran A. Alnajem

摘要

Background

Given the rising incidence of endometrial cancer in Saudi Arabia, the integration of high-cost therapeutics, such as dostarlimab (DSR), for primary advanced or recurrent (pA/rEC) disease necessitates rigorous economic appraisal. Therefore, this study aimed to evaluate the cost-utility of first-line dostarlimab plus carboplatin-paclitaxel (DSR + CP) versus placebo plus carboplatin-paclitaxel (PBO + CP) from the perspective of the Saudi healthcare payer.

Methods

A partitioned survival model was constructed to simulate patient prognosis across three health states: progression-free disease, progressive disease, and death. The model parameters were derived from the clinical efficacy data of the RUBY trial and the local cost inputs. The primary outcome was the incremental cost-effectiveness ratio (ICER), the robustness of which was evaluated via comprehensive deterministic and probabilistic sensitivity analyses to characterize parameter uncertainty.

Results

For the overall pA/rEC population, the DSR + CP regimen yielded an incremental 1.55 quality-adjusted life-years (QALYs) at an additional cost of $144,716, resulting in an ICER of $93,244 per QALY. Cost-effectiveness was more favorable in the mismatch repair deficient (dMMR) subgroup (ICER: $82,754/QALY) than in the mismatch repair proficient (pMMR) cohort (ICER: $132,571/QALY). The ICER is the most sensitive to the acquisition cost of the DSR. At a willingness-to-pay threshold of $90,000/QALY, the probability of DSR + CP being cost-effective was 83.9% for the dMMR subgroup.

Conclusion

This economic evaluation indicates that DSR + CP constitutes a cost-effective intervention for pA/rEC within the dMMR subpopulation. These findings provide strong evidence for a tailored reimbursement policy that effectively utilizes resources by connecting clinical benefits with economic value in the management of pA/rEC.