Cost-effectiveness analysis of Nivolumab plus Ipilimumab versus Nivolumab monotherapy in previously treated metastatic colorectal cancer patients with DNA mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) in China.

AIMS: This study evaluated the cost-effectiveness of Nivolumab plus Ipilimumab versus Nivolumab monotherapy in previously treated metastatic colorectal cancer (CRC) patients with DNA mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) in China. MATERIALS AND METHODS: An economic evaluation using a three-state partitioned survival model assessed the cost-effectiveness of Nivolumab plus Ipilimumab versus Nivolumab monotherapy. The Kaplan-Meier curves for overall survival and progression-free survival from a clinical trial were digitally extracted, and the Weibull model was applied to extrapolate long-term survival. RESULTS: The anticipated cost and utility of the Nivolumab plus Ipilimumab arm exceeded those of the Nivolumab monotherapy arm, respectively (322,575.67 USD vs. 188,409.23 USD; 3.88 QALYs vs. 2.57 QALYs). The ICER was 102,646.86 USD/QALY, suggesting that Nivolumab plus Ipilimumab was not cost-effective compared to Nivolumab monotherapy as the late-line treatment for metastatic CRC patients with dMMR/MSI-H. CONCLUSIONS: Nivolumab plus Ipilimumab was not cost-effective compared to Nivolumab monotherapy in previously treated metastatic CRC patients with dMMR/MSI-H in China.