Atezolizumab with chemotherapy in first-line treatment for metastatic urothelial cancer: a cost–effectiveness analysis

Abstract

Purpose: To evaluate the cost–effectiveness of atezolizumab plus chemotherapy as first-line treatment for metastatic urothelial cancer (mUC). Materials & methods: A Markov model was established for the analysis. Parametric survival models were used to fit to progression-free survival and overall survival data in the IMvigor130 study. A series of one-way and probabilistic sensitivity analyses were performed to test the robustness of the model. Results: The incremental cost–effectiveness ratios for atezolizumab plus chemotherapy versus chemotherapy alone were US$475,633.17 and $207,488.17 per quality-adjusted life year in the USA and China, respectively. Utility for the progression-free survival and progressive disease states, the cost of atezolizumab had the most significant impact on the incremental cost–effectiveness ratio. Conclusion: Atezolizumab plus chemotherapy is not a cost–effective treatment option as a first-line treatment for metastatic urothelial cancer.