Page 201 - EJMO-9-1

Eurasian Journal of Medicine
and Oncology

ORIGINAL RESEARCH ARTICLE
Cost-effectiveness of nivolumab plus

chemotherapy for advanced gastric/
gastroesophageal junction/esophageal

adenocarcinoma in the United States

4
Jin Zhou 1 , Wei Oy-Yang 2 , Xia Yin 3 , Han Zhan 3 , Jin Luo 3 , and Ge-Li Li *
1 Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
2 Department of Project Management, Hunan Institute of Microbiology, Hunan Academy of Agricultural
Sciences, Changsha, Hunan, China
3 Department of Oncology, 921 Hospital of Joint Logistic Support Force, The Chinese People’s
Liberation Army, Changsha, Hunan, China
4 Department of Oncology, Affiliated Hospital of Xiangnan University, Chenzhou, Hunan, China

Abstract

Nivolumab, in combination with chemotherapy, significantly improves survival
in patients with gastric/gastroesophageal junction (G/GEJ)/esophageal
adenocarcinoma. The study evaluated the cost-effectiveness of nivolumab plus
*Corresponding author: chemotherapy for the treatment of G/GEJ/esophageal adenocarcinoma. A Markov
Ge-Li Li model was developed from the perspective of United States healthcare payers. We
(19165664057@163.com)
estimated costs and summarized effectiveness in terms of quality-adjusted life-years
Citation: Zhou J, Oy-Yang W, (QALYs). One-way and probabilistic sensitivity analyses were conducted to assess
Yin X, Zhan H, Luo J, Li G.
Cost-effectiveness of nivolumab the impact of uncertainties on the cost-effectiveness results. The incremental cost-
plus chemotherapy for advanced effectiveness ratio for nivolumab plus chemotherapy ($149,636.97, 1.24 QALYs)
gastric/gastroesophageal junction/ compared to chemotherapy alone ($13,941.06, 0.75 QALYs) is $135,695.91, with
esophageal adenocarcinoma in
the United States. Eurasian J Med a difference of 0.49 QALYs. Evidence suggests that nivolumab plus chemotherapy
Oncol. 2025;9(1):193-203. for the first-line treatment of locally advanced or metastatic G/GEJ/esophageal
doi: 10.36922/ejmo.7075 adenocarcinoma may not represent a cost-effective option within the United States
Received: December 5, 2024 healthcare system.
Revised: January 2, 2025
Accepted: January 14, 2025 Keywords: Cost-effectiveness; Nivolumab; Metastatic gastric/gastroesophageal junction/
esophageal adenocarcinoma; Markov model
Published online: February 4,
2025
Copyright: © 2025 Author(s).
This is an Open-Access article 1. Introduction
distributed under the terms of the
Creative Commons Attribution Gastric/gastroesophageal junction (G/GEJ)/esophageal adenocarcinoma is considered a
License, permitting distribution,
and reproduction in any medium, relatively common cancer worldwide, with its incidence steadily increasing. At present,
provided the original work is gastric cancer ranks as the fifth most common cancer globally, while its fatality rate is
properly cited. the third highest among all cancers. Geographically, there has been a significant rise in
1
Publisher’s Note: AccScience incidence in East Asia and North America in recent years. Surgery remains the preferred
Publishing remains neutral with treatment for G/GEJ/esophageal adenocarcinoma; however, the prognosis is poor, with
regard to jurisdictional claims in 2,3
published maps and institutional postoperative recurrence rates reaching 50 – 70%. For patients with unresectable
affiliations. advanced-stage disease, alternative treatment options must be explored.

Volume 9 Issue 1 (2025) 193 doi: 10.36922/ejmo.7075