Immune checkpoint inhibitor-based first-line therapies for advanced or unresectable hepatocellular carcinoma: a network meta-analysis and cost-effectiveness analysis - PubMed

14 hours ago

Immune checkpoint inhibitors (ICIs) have transformed the treatment of advanced or unresectable hepatocellular carcinoma (HCC).
The study evaluates the cost-effectiveness and clinical efficacy of 12 first-line ICI-based therapies in China and the United States.
A network meta-analysis (NMA) included 11 randomized clinical trials with 7289 patients.
Four ICI-based regimens showed significantly improved overall survival (OS) and progression-free survival (PFS) compared to sorafenib.
In China, camrelizumab plus rivoceranib and tislelizumab were cost-effective, with ICERs of $17,624.64 and $1,971.14 per QALY, respectively.
In the United States, no ICI-based therapy was cost-effective at a $150,000 per QALY threshold; sorafenib remained the most cost-effective option.
Key factors influencing cost-effectiveness included drug costs, utility values, and discount rates.
Camrelizumab plus rivoceranib is a cost-effective first-line therapy in China, but current ICI-based therapies are not cost-effective in the US at existing prices.

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