Abstract
This study aimed to evaluate the cost-effectiveness of combination therapy of nivolumab plus chemotherapy (FOLFOX or XELOX) (Niv+Chemo) comparing with chemotherapy alone for patients with advanced gastric cancer (AGC) in Japan from the perspective of Japanese payer. Method: A partitioned survival model was developed to predict cost and quality-adjusted life years (QALYs) in a Niv+Chemo arm and a chemotherapy arm. Data on overall and progression-free survival was derived from the CheckMate649 trial. Cost estimates were based on Japanese payer perspective, by using real world data, JMDC claims database. Utilities were derived from previously published study. The incremental cost-effectiveness ratio (ICER) of Niv+Chemo therapy compared with chemotherapy was estimated. A subgroup analysis on the PD-L1 with a combined positive score (CPS) of five or more and one or more was conducted. In addition, deterministic sensitivity analysis was performed to assess the uncertainty in parameter setting.
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