{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T06:28:02Z","timestamp":1786343282208,"version":"build-2736575974"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multi-biomarker testing increasingly guides first-line therapy for advanced or metastatic gastric cancer in China, but its economic value is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a Chinese healthcare payer\u2013perspective cost-effectiveness analysis comparing a testing-guided pathway with No-testing, using a hybrid decision tree plus three-state Markov model for a 1,000-patient cohort over 10 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Testing-guided care increased costs by $64,242.13 and quality-adjusted life years (QALYs) by 0.63, yielding an incremental cost-effectiveness ratio (ICER) of $101,278.5\/QALY and failing to meet the willingness to pay (WTP) threshold. Probabilistic sensitivity analysis (PSA) showed 0% probability of cost-effectiveness at $40,629\/QALY; key one-way drivers included progression-free (PF) utility and zolbetuximab cost.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Biomarker-guided treatment improved outcomes but was not cost-effective in China at current prices, mainly due to high drug costs in large biomarker-defined groups. Value-based pricing may improve affordability and cost-effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1840088","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T05:31:16Z","timestamp":1786339876000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-effectiveness of targeted therapy versus chemotherapy for patients with advanced or metastatic gastric cancer in China"],"prefix":"10.3389","volume":"17","author":[{"given":"Kehui","family":"Meng","sequence":"first","affiliation":[{"name":"Department of Pharmacy, The Second Xiangya Hospital, Central South University","place":["Changsha, Hunan, China"]},{"name":"Institute of Clinical Pharmacy, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiyu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Xiangya Hospital, Central South University","place":["Changsha, Hunan, China"]},{"name":"Institute of Clinical Pharmacy, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Xiangya Hospital, Central South University","place":["Changsha, Hunan, China"]},{"name":"Institute of Clinical Pharmacy, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Xiangya Hospital, Central South University","place":["Changsha, Hunan, China"]},{"name":"Institute of Clinical Pharmacy, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangke","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Xiangya Hospital, Central South University","place":["Changsha, Hunan, China"]},{"name":"Institute of Clinical Pharmacy, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaohao","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Xiangya Hospital, Central South University","place":["Changsha, Hunan, China"]},{"name":"Institute of Clinical Pharmacy, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomin","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Xiangya Hospital, Central South University","place":["Changsha, Hunan, China"]},{"name":"Institute of Clinical Pharmacy, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chongqing","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Second Xiangya Hospital, Central South University","place":["Changsha, Hunan, China"]},{"name":"Institute of Clinical Pharmacy, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"He","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital of Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"169","DOI":"10.6004\/jnccn.2025.0022","article-title":"Gastric cancer, version 2.2025, NCCN clinical practice guidelines in oncology","volume":"23","author":"Ajani","year":"2025","journal-title":"J. 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