Tisotumab vedotin for patients with recurrent or metastatic cervical cancer: a cost-effectiveness analysis

Novel antibody–drug conjugates (ADCs) offer cancer patients a growing range of promising therapeutic options. Tisotumab vedotin (TV) has been reported to significantly prolong recurrent or metastatic cervical cancer (R/M CC) patient clinical survival. To support its clinical adoption, this study aimed to assess the cost-effectiveness of TV for R/M CC. The lifetime disease course of R/M CC patients was simulated using a Markov survival model that included three health states, which was used to estimate the costs and therapeutic outcomes associated with TV and chemotherapeutic treatment for these patients in accordance with the findings of the innovaTV 301/ENGOT-cx12/GOG-3057 trial. Primary study outcomes included total costs, life years (LYs), quality-adjusted LYs (QALYs), incremental cost-effectiveness ratio (ICER) values, and incremental net-health benefit (INHB) that were evaluated at willingness-to-pay (WTP) thresholds of $36,395/QALY (UK) and $35,139/QALY (China). TV costs in the UK and China ($157,746 and $198,262) were $89,078 and $189,776 higher than those associated with chemotherapy ($68,668 and $8,486), but TV treatment was also associated with incremental gains of 2.46 QALYs and 0.92 QALYs more (29.45 vs. 26.99 QALYs and 12.76 vs. 11.84 QALYs), respectively. These values yielded respective ICERs of $36,272/QALY and $206,126/QALY and corresponding INHB values of 0.01 and − 4.48 QALYs. The weight of treated patients and the costs of TV were the factors that most strongly influenced these results. TV utilization represents a cost-effective second-/third-line approach to systemic R/M CC patient treatment in the UK but not in China.