Measuring the Cost-Effectiveness of Dostarlimab Plus Carboplatin-Paclitaxel in Endometrial Cancer Treatment
A study published in Gynecologic Oncology finds that dostarlimab plus carboplatin-paclitaxel (CP) may be a cost-effective first-line treatment for patients primary advanced or recurrent endometrial cancer (pA/rEC).
A significant percentage of patients with endometrial cancer experience recurrence, leading to poor prognosis. Recent US Food and Drug Administration (FDA) approvals have introduced new treatment options, including dostarlimab plus CP, sparking the need for cost-effectiveness analysis to evaluate its value as a first-line treatment for this population.
The study developed a survival model with 3 distinct health states: progression-free disease, progressed disease, and death. Data from the RUBY trial and other published sources were used to inform the model, while costs were based on US databases. The primary outcomes of the analysis included life-years, quality-adjusted life-years (QALYs), incremental costs, and incremental cost-effectiveness ratios (ICERS), with sensitivity analyses conducted to test the robustness of the results.
The model predicted higher gains in life-years and QALYs with dostarlimab plus CP compared with CP in the population with deficient DNA mismatch repair (dMMR) and microsatellite instability-high (MSI-H). There was also a higher cost, resulting in an ICER of $57 151 per QALY gained. In the overall population, the gains were lower with a higher cost, resulting in an ICER of $143 783 per QALY gained. The cost-effectiveness probabilities of dostarlimab plus CP were 100% and 53.7% at a willingness-to-pay threshold of $150 000 in the dMMR/MSI-H and overall populations, respectively.
“Dostarlimab plus CP is cost-effective as a treatment for the dMMR/MSI-H and overall populations of US patients with pA/rEC,” said researchers.
Reference
Coleman R L, Lubinga S L, Shen Q, Walder L, Burton M, Mathews C. Cost-effectiveness of dostarlimab plus carboplatin-paclitaxel for primary advanced or recurrent endometrial cancer from a US payer perspective. Gynecol Onco. 2025;192:24-31. doi:10.1016/j.ygyno.2024.10.021.
