The rising incidence of liver cancer requires robust economic evaluations for novel therapies. Consequently, a recent study examined immune checkpoint inhibitor cost-effectiveness for unresectable hepatocellular carcinoma (uHCC) in China. Researchers aimed to identify the most sustainable first-line options within a finite healthcare budget. The investigation focused on regimens relevant to clinical practice, including newly approved combinations and monotherapies.

Methodology and Evaluation Framework

Researchers synthesized relative efficacy data from six phase III clinical trials. Therefore, they used a Bayesian network meta-analysis with Royston-Parmar models to account for non-proportional hazards. The study utilized a three-state partitioned survival model over a 10-year horizon. Furthermore, analysts discounted annual costs and quality-adjusted life-years (QALYs) at 5%. This structured approach allowed for a comprehensive comparison of various regimens against sorafenib.

Analyzing Immune Checkpoint Inhibitor Cost-Effectiveness

The results showed that camrelizumab-rivoceranib provided more QALYs at a lower cost than three other combinations. Specifically, it dominated anlotinib-penpulimab, sintilimab-bevacizumab biosimilar, and toripalimab-bevacizumab. However, the study identified tislelizumab as the most cost-effective choice overall. Its incremental cost per QALY gained was $10,715 compared to sorafenib. Notably, this figure remains well below the established willingness-to-pay threshold of $40,344. Moreover, atezolizumab-bevacizumab showed a much higher incremental cost, reaching $294,795 per QALY gained.

Clinical and Policy Implications

Sensitivity analyses confirmed that these findings remained robust despite structural or parameter uncertainties. Consequently, tislelizumab represents a viable first-line option for patients within the Chinese healthcare system. Healthcare providers can use this evidence to optimize resource allocation. Furthermore, such data assist policymakers in negotiating drug pricing and insurance coverage. Ultimately, prioritizing cost-effective regimens ensures that more patients receive high-quality oncological care without exhausting available funds.

Frequently Asked Questions

Which drug was found most cost-effective for uHCC?

Tislelizumab was identified as the most cost-effective first-line immune checkpoint inhibitor for unresectable hepatocellular carcinoma, falling well within the standard willingness-to-pay thresholds.

What is the significance of the dominance of camrelizumab-rivoceranib?

Camrelizumab-rivoceranib established strict dominance because it provided greater clinical benefit at a lower cost compared to several other immune checkpoint inhibitor combinations tested in the study.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice or a professional recommendation. It is not a substitute for professional clinical judgment. Refer to the latest local and national guidelines for clinical practice.

References

Li W et al. Cost-effectiveness of first-line immune checkpoint inhibitor therapies, alone or combined with targeted agents, for unresectable hepatocellular carcinoma in China: an economic evaluation using network meta-analysis. Immunotherapy. 2026 Mar 20. doi: 10.1080/1750743X.2026.2647585. PMID: 41860583.

Wang L, Peng Y, Qin S, et al. First-line systemic treatment strategies for unresectable hepatocellular carcinoma: A cost-effectiveness analysis. PLoS ONE. 2023;18(4):e0279786. doi:10.1371/journal.pone.0279786.

Gordan LN, et al. Systemic Therapy for Advanced Hepatocellular Carcinoma: ASCO Guideline Update. J Clin Oncol. 2024. doi: 10.1200/JCO.23.01234.