COST-EFFECTIVENESS ANALYSIS OF ATEZOLIZUMAB PLUS BEVACIZUMAB COMBINATION THERAPY AS FIRST-LINE TREATMENT FOR UNRESECTABLE HEPATOCELLULAR CARCINOMA...
Author(s)
Ryutaro Sakai1, Koshi Naito, BS2, Kensuke Moriwaki, BS, MS, PhD3, Mao Yamaguchi, MS4, Seiya Taniguchi, MS5.
1Student, Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan University, Kusatu, Japan, 3Ritsumeikan University, Kyoto, Japan, 4Ritsumeikan university, Kusatsu, Japan, 5Ritsumeikan University, Kusatsu, Japan.
1Student, Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan University, Kusatu, Japan, 3Ritsumeikan University, Kyoto, Japan, 4Ritsumeikan university, Kusatsu, Japan, 5Ritsumeikan University, Kusatsu, Japan.
OBJECTIVES: The efficacy of atezolizumab plus bevacizumab combination therapy as first-line treatment for unresectable hepatocellular carcinoma has been demonstrated, its cost-effectiveness in Japan remains unclear. This study aimed to evaluate the cost-effectiveness of atezolizumab plus bevacizumab combination therapy compared with sorafenib monotherapy as first-line treatment for unresectable hepatocellular carcinoma in Japan.
METHODS: To evaluate atezolizumab plus bevacizumab versus sorafenib, a partitioned survival analysis (PartSA) was developed using IMbrave150 trial data. From a Japanese public payer perspective, the study calculated long-term costs and QALYs, incorporating domestic drug prices and utility values. The Incremental Cost-Effectiveness Ratio (ICER) was compared against Japan’s willingness-to-pay threshold. Finally, sensitivity analyses addressed model uncertainties, providing a robust assessment of the combination therapy's value within the Japanese healthcare system.
RESULTS: The ICER of atezolizumab plus bevacizumab combination therapy compared with sorafenib was 41,178,441 JPY/QALY. The deterministic sensitivity analysis showed that the parameter with the greatest impact on the ICER was the post-progression utility value in the atezolizumab plus bevacizumab combination therapy group.
CONCLUSIONS: When a willingness-to-pay threshold of 15 million JPY/QALY was applied, atezolizumab plus bevacizumab combination therapy was not shown to be cost-effective as first-line treatment for unresectable hepatocellular carcinoma. The results of the probabilistic sensitivity analysis suggested that the utility value settings had a substantial impact on the ICER.
METHODS: To evaluate atezolizumab plus bevacizumab versus sorafenib, a partitioned survival analysis (PartSA) was developed using IMbrave150 trial data. From a Japanese public payer perspective, the study calculated long-term costs and QALYs, incorporating domestic drug prices and utility values. The Incremental Cost-Effectiveness Ratio (ICER) was compared against Japan’s willingness-to-pay threshold. Finally, sensitivity analyses addressed model uncertainties, providing a robust assessment of the combination therapy's value within the Japanese healthcare system.
RESULTS: The ICER of atezolizumab plus bevacizumab combination therapy compared with sorafenib was 41,178,441 JPY/QALY. The deterministic sensitivity analysis showed that the parameter with the greatest impact on the ICER was the post-progression utility value in the atezolizumab plus bevacizumab combination therapy group.
CONCLUSIONS: When a willingness-to-pay threshold of 15 million JPY/QALY was applied, atezolizumab plus bevacizumab combination therapy was not shown to be cost-effective as first-line treatment for unresectable hepatocellular carcinoma. The results of the probabilistic sensitivity analysis suggested that the utility value settings had a substantial impact on the ICER.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
HTA5
Topic
Health Technology Assessment
Disease
SDC: Oncology