The cost-effectiveness of zolbetuximab in CLDN18.2-positive gastric or gastroesophageal junction adenocarcinoma

Pharmacogenomics. 2024;25(5-6):249-257. doi: 10.1080/14622416.2024.2344438. Epub 2024 May 10.

Abstract

Aim: To estimate the cost-effectiveness of zolbetuximab plus capecitabine/oxaliplatin (CAPOX) in CLDN18.2-positive, HER2-negative, mG/GEJ adenocarcinoma from the perspective of Chinese payers.Materials & methods: A partitioned survival model was developed to assess the costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICER) of zolbetuximab plus CAPOX versus placebo plus CAPOX. Sensitivity analyses were performed to test the robustness of model.Results: Zolbetuximab plus CAPOX gained an additional cost of $91,551 and an extra health benefit of 0.24 QALY over placebo plus CAPOX, producing an ICER of $388,186/QALY, which exceeded the willingness-to-pay threshold of $38,223/QALY. Sensitivity analysis shows that the model was generally robust.Conclusion: Zolbetuximab plus CAPOX would not be a cost-effective first-line treatment regimen in CLDN18.2-positive, HER2-negative, mG/GEJ adenocarcinoma in China.

Keywords: CLDN18.2 protein; cost–effectiveness; gastric or gastroesophageal junction adenocarcinoma; value-based pricing; zolbetuximab.

Plain language summary

[Box: see text].

MeSH terms

  • Adenocarcinoma* / drug therapy
  • Adenocarcinoma* / genetics
  • Antibodies, Monoclonal / economics
  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols* / economics
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Capecitabine / economics
  • Capecitabine / therapeutic use
  • China
  • Claudins* / genetics
  • Cost-Benefit Analysis*
  • Esophageal Neoplasms / drug therapy
  • Esophagogastric Junction* / pathology
  • Humans
  • Oxaliplatin / economics
  • Oxaliplatin / therapeutic use
  • Quality-Adjusted Life Years*
  • Stomach Neoplasms* / drug therapy

Substances

  • Claudins
  • CLDN18 protein, human
  • Oxaliplatin
  • Capecitabine
  • Antibodies, Monoclonal