Cost-effectiveness of nivolumab combined with chemotherapy as a first-line therapy for patients with unresectable or metastatic urothelial carcinoma

Evaluating the cost-effectiveness of nivolumab and chemotherapy for advanced bladder cancer treatment Our study compared a cancer treatment called nivolumab-combination with the standard chemotherapy called gemcitabine-cisplatin for people with a type of cancer called “urothelial carcinoma” that has spread or cannot be removed by surgery. We found that while nivolumab-combination slightly improves quality and length of life, it’s much more expensive. We calculated a number called the “ICER” to help us decide if the extra cost is worth it. The ICER was much higher than what we usually consider a good value, which is $100,000 per extra year of good health. We also discovered that the high drug cost of nivolumab affected the cost-effectiveness most. If all drug prices were like in the UK or Australia, the treatment could be affordable. In short, based on our analysis, nivolumab-combination wasn’t a cost-effective first-line treatment for this cancer from a U.S. healthcare payer’s viewpoint, especially considering the $100,000/QALY threshold. This highlights the need for negotiation on drug pricing and health policy to improve access to affordable treatments.