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. 2025 Jun;21(15):1919-1927.
doi: 10.1080/14796694.2025.2504321. Epub 2025 May 10.

Economic evaluation of Erdafitinib as a second-line treatment for advanced metastatic urothelial carcinoma: real-world data from the USA and prospective analysis from China

Andong Li  1   2 , Meiyu Wu  1   2 , Ouyang Xie  1   2 , Heng Xiang  1   2 , Kehui Meng  1   2 , Xiaomin Wan  1   2
Affiliations

Economic evaluation of Erdafitinib as a second-line treatment for advanced metastatic urothelial carcinoma: real-world data from the USA and prospective analysis from China

Andong Li et al. Future Oncol. 2025 Jun.

Abstract

Background and objective: Metastatic urothelial carcinoma (mUC) is challenging to treat, with 37% of patients failing first-line therapy. Effective second-line treatments, like Erdafitinib, are crucial. This study evaluates the cost-effectiveness of Erdafitinib as a second-line treatment for mUC from US and Chinese payer perspectives.

Methods: A Markov model was developed to project costs, life years, and quality-adjusted life years (QALYs) over lifetime. Data were collected from December 2023 to December 2024 for up-to-date estimates and were obtained from literature, health databases, and clinical trials.. The model was run to project long-term outcomes for both the United States and China.

Results: In the United States, Erdafitinib provides an additional 0.467 QALYs at a cost of $238,294.2 per QALY, which exceeds the $150,000 per QALY willingness-to-pay threshold. For China, when the cost of Erdafitinib is below $6.9 or $14 per milligram, there is a 90% probability that its incremental cost-effectiveness ratio will be below $38,223 or $84,966 per QALY, respectively.

Conclusions: From the perspective of U.S. payers, Erdafitinib as a second-line treatment for mUC is not cost-effective. From the perspective of China, the cost-effectiveness of Erdafitinib is highly sensitive to its price, which could provide a reference for healthcare reimbursement negotiations.

Keywords: China; Erdafitinib; United States; cost-effectiveness; metastatic urothelial carcinoma.

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Conflict of interest statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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