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. 2025 Jan:192:24-31.
doi: 10.1016/j.ygyno.2024.10.021. Epub 2024 Nov 8.

Cost-effectiveness of dostarlimab plus carboplatin-paclitaxel for primary advanced or recurrent endometrial cancer from a US payer perspective

Robert L Coleman  1 , Solomon J Lubinga  2 , Qin Shen  2 , Lydia Walder  3 , Mark Burton  3 , Cara Mathews  4
Affiliations

Cost-effectiveness of dostarlimab plus carboplatin-paclitaxel for primary advanced or recurrent endometrial cancer from a US payer perspective

Robert L Coleman et al. Gynecol Oncol. 2025 Jan.

Abstract

Objective: Dostarlimab in combination with carboplatin-paclitaxel (CP) improves progression-free survival in patients with primary advanced or recurrent endometrial cancer (pA/rEC), including in patients whose cancer is mismatch repair-deficient (dMMR) or microsatellite instability-high (MSI-H). This study examined the cost-effectiveness of dostarlimab plus CP as a first-line treatment in the dMMR/MSI-H and overall populations.

Methods: A partitioned survival model with three mutually exclusive health states (progression-free disease, progressed disease, death) was developed using a US base case and a third-party payer perspective. Clinical data were from the RUBY trial and published sources. Costs were from US databases. The primary outcomes were life-years (LYs), quality-adjusted life-years (QALYs), incremental costs, and incremental cost-effectiveness ratios (ICERs). One-way and probabilistic sensitivity analyses were also performed.

Results: In the dMMR/MSI-H population, the model predicted gains of 6.9 LYs and 5.4 QALYs with dostarlimab plus CP compared with CP; costs were $307,696 higher with dostarlimab plus CP, resulting in an ICER of $57,151 per QALY gained. In the overall population, gains of 2.0 LYs and 1.5 QALYs were predicted with dostarlimab plus CP compared with CP; costs were $215,876 higher, resulting in an ICER of $143,783 per QALY gained. ICERs were most sensitive to the overall survival hazard ratio. At a willingness-to-pay threshold of $150,000, dostarlimab plus CP had cost-effectiveness probabilities of 100 % and 53.7 % in the dMMR/MSI-H and overall populations, respectively.

Conclusions: Dostarlimab plus CP is cost-effective as a treatment for the dMMR/MSI-H and overall populations of US patients with pA/rEC.

Keywords: Carboplatin-paclitaxel; Cost-effectiveness model; Dostarlimab; Endometrial cancer.

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Conflict of interest statement

Declaration of competing interest RLC discloses grants or contracts from AstraZeneca, Clovis, Genelux, Genmab, Merck, Immunogen, Roche/Genentech, and Karyopharm; royalties or licenses from Up-To-Date; consultancy for Agenus, Alkermes, AstraZeneca, Clovis, Deciphera, Genelux, Genmab, GSK, Immunogen, OncoQuest, Onxerna, Regeneron, Karyopharm, Roche/Genentech, Novocure, Merck, and Abbvie; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, Clovis, Roche/Genentech, and Merck; participation on data safety monitoring or advisory boards from NRG Oncology and Eisai/BMS; and leadership or fiduciary roles in Onxeo/Valerio, Vaniam Group, GOG Foundation, International Gynecologic Cancer Society, OCNA and Ovarcome. SJL discloses employment with GSK, GSK funding for meetings/travel and ownership of GSK stock. QS discloses employment with GSK and ownership of GSK stock. LW and MB disclose consultancy for GSK and employment with FIECON, which received consultancy fees from GSK. CM discloses grants or contracts from Deciphera, Astellas Pharma, Seagen, Genmab, EMD Serono, Merck, Regeneron, Moderna, Astra Zeneca, AvengeBio, Zentalis, GSK, Immunogen, Elucida, Roche/Genentech, Pfizer, Laekna, Artios, Volatra, and AADI. This study was funded by GSK; editorial and writing support was provided by Nucleus Global, which received funding from GSK.

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