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. 2025 Jun 25:16:1594786.
doi: 10.3389/fimmu.2025.1594786. eCollection 2025.

Cost-effectiveness analysis of cadonilimab plus bevacizumab and chemotherapy for persistent, recurrent, or metastatic cervical cancer

Kaixuan Wang  1 , Shixian Liu  2 , Ruixue Wang  3 , Lei Dou  2 , Jie Gao  1
Affiliations

Cost-effectiveness analysis of cadonilimab plus bevacizumab and chemotherapy for persistent, recurrent, or metastatic cervical cancer

Kaixuan Wang et al. Front Immunol. .

Abstract

Objective: The aim of this study is to investigate the cost-effectiveness of cadonilimab plus bevacizumab and chemotherapy in the first-line treatment for patients with persistent, recurrent, or metastatic cervical cancer from a healthcare system perspective in China.

Methods: A partitioned survival model was established to estimate the total costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) over a 10-year time horizon. Clinical data was sourced from the COMPASSION-16 trial; direct medical costs and utilities were obtained from a public drug bidding database and published literature. The robustness of the model was assessed via scenario, one-way and probabilistic sensitivity analyses.

Results: Cadonilimab plus bevacizumab and chemotherapy yielded an additional cost of $31,654.02, with an additional QALY of 0.36, resulted in an ICER of $88,533.51/QALY compared with bevacizumab and chemotherapy. Utility values of progression-free survival (PFS), patient weight and price of cadonilimab were the most influential parameter on ICER. The probability of cadonilimab plus bevacizumab and chemotherapy being cost-effective was 0% at the WTP threshold of $38,042.49 per QALY. When the price of cadonilimab reduced by 72%, cadonilimab plus bevacizumab and chemotherapy would represent an economically viable treatment regime.

Conclusion: Cadonilimab plus bevacizumab and chemotherapy may not be a cost-effective option as the first-line treatment in persistent, recurrent, or metastatic cervical cancer.

Keywords: bevacizumab; cadonilimab; cervical cancer; chemotherapy; cost-effectiveness.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The structure of the partitioned survival model.
Figure 2
Figure 2
Scenario analysis results for price reductions of cadonilimab. ICER, incremental cost-effectiveness ratio; WTP, willingness to Pay.
Figure 3
Figure 3
Tornado diagram of one-way sensitivity analysis results. ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life year; CBC, cadonilimab plus bevacizumab and chemotherapy; BC, bevacizumab and chemotherapy; PFS, progression-free survival; PD, progressive disease.
Figure 4
Figure 4
The incremental cost-effectiveness scatter plot of cadonilimab plus bevacizumab and chemotherapy compared to bevacizumab and chemotherapy in China. QALY, quality-adjusted life year; WTP, willingness to Pay.
Figure 5
Figure 5
The cost-effectiveness acceptability curve of the probabilistic sensitivity analysis results. CBC, cadonilimab plus bevacizumab and chemotherapy; BC, bevacizumab and chemotherapy; QALY, quality-adjusted life year; WTP, willingness to Pay.
See this image and copyright information in PMC

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