Nivolumab-AVD versus Brentuximab Vedotin-AVD as First-Line Treatment for Advanced-Stage Classical Hodgkin Lymphoma: A Cost-Effectiveness Analysis

Objective: To evaluate the cost-effectiveness of nivolumab plus doxorubicin/vinblastine/dacarbazine (N-AVD) versus brentuximab vedotin-AVD (BV-AVD) as first-line treatment for advanced-stage classical Hodgkin lymphoma. Design: Cost-effectiveness analysis using a Markov model based on the S1826 trial (n=970). We estimated total direct costs, life-years (LYs), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICER). Sensitivity analyses assessed robustness. Results: Nivolumab-AVD yielded 6.560 QALYs and 15.659 LYs, representing gains of 0.504 QALYs and 0.551 LYs over Brentuximab vedotin-AVD. Total costs were $784,839 for Nivolumab-AVD compared with $789,205 for Brentuximab vedotin-AVD. Nivolumab-AVD was associated with negative incremental cost-effectiveness ratios (-$8,656 per QALY; -$7,926 per LY) and was dominant, offering superior health outcomes at a lower overall cost. Conclusion: From a Chinese healthcare payer perspective, nivolumab-AVD is more cost-effective than brentuximab vedotin-AVD for advanced-stage classical Hodgkin lymphoma, offering lower costs and better health outcomes.