Cost-effectiveness of disitamab vedotin plus toripalimab versus chemotherapy alone as first-line treatment for HER2-overexpressing advanced urothelial carcinoma: a cost-effectiveness analysis from the Chinese healthcare system perspective
Abstract
BackgroundThe antibody-drug conjugate disitamab vedotin (DV) in combination with the programmed death receptor-1 (PD-1) inhibitor toripalimab has demonstrated favorable efficacy and a manageable safety profile in patients with HER2-expressing advanced urothelial carcinoma (AUC), as evidenced by the pivotal RC48–016 clinical trial. Nevertheless, the economic viability of this combination strategy relative to conventional chemotherapy remains inadequately characterized. This study sought to evaluate the cost-effectiveness of the aforementioned combination regimen as first-line therapy for HER2-overexpressing AUC patients within the Chinese healthcare system.MethodsLeveraging clinical data derived from the RC48–016 trial, a partitioned survival model (PSM) was developed to project long-term survival outcomes and healthcare resource consumption among HER2-overexpressing AUC patients receiving either DV plus toripalimab or chemotherapy alone. Primary outcome measures encompassed total costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). The willingness-to-pay (WTP) threshold was established at twice China’s 2024 per capita gross domestic product (GDP), amounting to $26,889.37 per QALY. Sensitivity analyses were undertaken to ascertain the robustness of the model findings.ResultsThe chemotherapy-alone arm incurred total costs of $80,979.23, yielding 1.54 QALYs. Relative to chemotherapy alone, the DV plus toripalimab regimen was associated with an incremental cost of $5,696.81 and an incremental health gain of 0.89 QALYs, translating to an ICER of $6,433.19 per QALY—substantially below the prespecified WTP threshold. Sensitivity analyses identified the discount rate and the acquisition cost of disitamab vedotin as the principal drivers of ICER variation; nonetheless, ICER estimates remained below the WTP threshold across all scenarios examined, attesting to the robustness of the model conclusions.ConclusionWithin the Chinese healthcare context, DV plus toripalimab as first-line treatment for HER2-overexpressing AUC confers meaningful survival benefits without imposing a prohibitive economic burden, thereby demonstrating favorable cost-effectiveness and representing a therapeutically valuable strategy with economic merit.
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BibTeX
@article{liu2026costeffectiveness,
title = {{Cost-effectiveness of disitamab vedotin plus toripalimab versus chemotherapy alone as first-line treatment for HER2-overexpressing advanced urothelial carcinoma: a cost-effectiveness analysis from the Chinese healthcare system perspective}},
author = {Yang Liu and Lin Qiao and Xiaofei Li and Rongguo Shang and Wei Chen and Yiwen Li and Hangmei Liu and Lili Zhang and Shui Liu},
journal = {Frontiers in Oncology},
year = {2026},
month = nov,
doi = {10.3389/fonc.2026.1798733},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1798733},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Cost-effectiveness of disitamab vedotin plus toripalimab versus chemotherapy alone as first-line treatment for HER2-overexpressing advanced urothelial carcinoma: a cost-effectiveness analysis from the Chinese healthcare system perspective
AU - Yang Liu
AU - Lin Qiao
AU - Xiaofei Li
AU - Rongguo Shang
AU - Wei Chen
AU - Yiwen Li
AU - Hangmei Liu
AU - Lili Zhang
AU - Shui Liu
PY - 2026
DA - 2026/11/04
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1798733
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1798733
AB - BackgroundThe antibody-drug conjugate disitamab vedotin (DV) in combination with the programmed death receptor-1 (PD-1) inhibitor toripalimab has demonstrated favorable efficacy and a manageable safety profile in patients with HER2-expressing advanced urothelial carcinoma (AUC), as evidenced by the pivotal RC48–016 clinical trial. Nevertheless, the economic viability of this combination strategy relative to conventional chemotherapy remains inadequately characterized. This study sought to evaluate the cost-effectiveness of the aforementioned combination regimen as first-line therapy for HER2-overexpressing AUC patients within the Chinese healthcare system.MethodsLeveraging clinical data derived from the RC48–016 trial, a partitioned survival model (PSM) was developed to project long-term survival outcomes and healthcare resource consumption among HER2-overexpressing AUC patients receiving either DV plus toripalimab or chemotherapy alone. Primary outcome measures encompassed total costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). The willingness-to-pay (WTP) threshold was established at twice China’s 2024 per capita gross domestic product (GDP), amounting to $26,889.37 per QALY. Sensitivity analyses were undertaken to ascertain the robustness of the model findings.ResultsThe chemotherapy-alone arm incurred total costs of $80,979.23, yielding 1.54 QALYs. Relative to chemotherapy alone, the DV plus toripalimab regimen was associated with an incremental cost of $5,696.81 and an incremental health gain of 0.89 QALYs, translating to an ICER of $6,433.19 per QALY—substantially below the prespecified WTP threshold. Sensitivity analyses identified the discount rate and the acquisition cost of disitamab vedotin as the principal drivers of ICER variation; nonetheless, ICER estimates remained below the WTP threshold across all scenarios examined, attesting to the robustness of the model conclusions.ConclusionWithin the Chinese healthcare context, DV plus toripalimab as first-line treatment for HER2-overexpressing AUC confers meaningful survival benefits without imposing a prohibitive economic burden, thereby demonstrating favorable cost-effectiveness and representing a therapeutically valuable strategy with economic merit.
SN - 2234-943X
ER -