Presentation (CTI)

OBJECTIVES: Tisotumab Vedotin (TV) is used as a second- or later-line treatment for recurrent or metastatic cervical cancer, and the innovaTV 301 trial demonstrated significant improvements in overall survival (OS) and progression-free survival (PFS). Although novel therapies are needed due to the poor prognosis of recurrent or metastatic cervical cancer, antibody-drug conjugates (ADCs) are generally expensive, raising concerns regarding their cost-effectiveness. This study aimed to evaluate the cost-effectiveness of TV in Japanese patients with recurrent or metastatic cervical cancer.
METHODS: A partitioned survival analysis model was developed to estimate costs and quality-adjusted life years (QALYs) for three health states (progression-free survival, progressed disease, and death). Survival data were obtained from the phase III innovaTV 301 trial. Drug costs for TV were calculated based on the National Health Insurance drug price list in Japan. Other cost parameters were derived from analyses of the JMDC claims database. Utility values were obtained from published literature. The incremental cost-effectiveness ratio (ICER) was calculated, and deterministic and probabilistic sensitivity analyses were conducted to assess parameter uncertainty.
RESULTS: The incremental cost-effectiveness ratio (ICER) of TV compared with chemotherapy was estimated at 44,187,777 JPY/QALY gained. At the willingness-to-pay (WTP) threshold for anticancer drugs in Japan (15,000,000 JPY/QALY), the ICER of TV substantially exceeded the threshold. In addition, probabilistic sensitivity analysis indicated that the probability that TV was cost-effective relative to chemotherapy was 18.5%. These findings suggest that TV may not be cost-effective compared with chemotherapy in Japan.
CONCLUSIONS: At a willingness-to-pay threshold of 15,000,000 JPY/QALY, TV was not considered cost-effective compared with chemotherapy for patients with recurrent or metastatic cervical cancer in Japan.