{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:43:46Z","timestamp":1781138626646,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"22","license":[{"start":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T00:00:00Z","timestamp":1663286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82160763"],"award-info":[{"award-number":["82160763"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2022,11,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The cost effectiveness of atezolizumab plus bevacizumab (atezo\u2010beva) versus nivolumab treatment for advanced or unresectable hepatocellular carcinoma is still uncertain. In this study, the cost effectiveness of these treatments was assessed in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cost\u2010effectiveness analysis integrating a network meta\u2010analysis framework was performed using data from the IMbrave150 (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> identifier NCT03434379) and CheckMate 459 (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> identifier NCT02576509) trials. In total, 1244 patients were enrolled. A partitioned survival model was used to evaluate cost effectiveness. A deterministic one\u2010way sensitivity analysis and probabilistic sensitivity analyses were further performed to evaluate model robustness. Subgroup analyses were also performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with the outcomes using nivolumab, the hazard ratio (HR) for overall survival with atezo\u2010beva was 0.68 (95% CI, 0.48\u20130.98), and the HR for progression\u2010free survival was 0.63 (95% CI, 0.47\u20130.85). Atezo\u2010beva treatment was associated with an increase of 1.13 life\u2010years and an increase of 0.69 quality\u2010adjusted life\u2010years (QALYs), as well as a $78,280 increase in cost per patient. The incremental cost\u2010effectiveness ratio was $113,892 per QALY. The incremental net health benefit and the incremental net monetary benefit were 0.17 QALYs and $24,770, respectively, at a willingness\u2010to\u2010pay (WTP) threshold of $150,000 per QALY. The model was most sensitive to the HR for progression\u2010free survival. The probability of atezo\u2010beva being considered cost effective was 78%, and it was &gt;50% in most of the subgroups at the WTP threshold of $150,000 per QALY.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>At a WTP threshold of $150,000 per QALY and under current drug pricing, atezo\u2010beva is likely considered cost\u2010effective as a first\u2010line treatment for advanced or unresectable hepatocellular carcinoma compared with nivolumab.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34457","type":"journal-article","created":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T09:19:26Z","timestamp":1663319966000},"page":"3995-4003","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Atezolizumab plus bevacizumab versus nivolumab as first\u2010line treatment for advanced or unresectable hepatocellular carcinoma: A cost\u2010effectiveness analysis"],"prefix":"10.1002","volume":"128","author":[{"given":"Yan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pharmacy Guangxi Academy of Medical Sciences and People's Hospital of Guangxi Zhuang Autonomous Region  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueyan","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Guangxi Academy of Medical Sciences and People's Hospital of Guangxi Zhuang Autonomous Region  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Guangxi Academy of Medical Sciences and People's Hospital of Guangxi Zhuang Autonomous Region  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2924-3618","authenticated-orcid":false,"given":"Xiaoyu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Guangxi Academy of Medical Sciences and People's Hospital of Guangxi Zhuang Autonomous Region  Nanning Guangxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30010-2"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12818"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30207-1"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0000000000000327"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature14011"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2005.05.132"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2008.01762.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20140559"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms12624"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1915745"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.0037"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.4846"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00604-5"},{"key":"e_1_2_8_16_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins J","year":"2020"},{"key":"e_1_2_8_17_1","doi-asserted-by":"crossref","first-page":"e067975","DOI":"10.1136\/bmj-2021-067975","article-title":"Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) statement: updated reporting guidance for health economic evaluations","volume":"376","author":"Husereau D","year":"2022","journal-title":"BMJ."},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1607591"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X16670617"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-12-9"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0207132"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.3747\/co.23.2244"},{"key":"e_1_2_8_23_1","article-title":"ASP Drug Pricing Files","volume":"2022","author":"Centers for Medicare & Medicaid Services (CMS)","year":"2022","journal-title":"CMS"},{"key":"e_1_2_8_24_1","unstructured":"IBM Corporation.RED BOOK for drug pricing drug data and manufacturer information. 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