{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T06:02:32Z","timestamp":1789970552280,"version":"4.0.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"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>Pembrolizumab plus weekly paclitaxel, with or without bevacizumab, improves survival in programmed death ligand 1 (PD-L1)\u2013positive platinum-resistant recurrent ovarian cancer, but its economic value remains uncertain. This study evaluated the cost-effectiveness of pembrolizumab plus weekly paclitaxel versus placebo plus weekly paclitaxel in patients with PD-L1 combined positive score \u22651 platinum-resistant recurrent ovarian cancer from the Chinese and United States (US) healthcare system perspectives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A partitioned survival model was developed using data from ENGOT-ov65\/KEYNOTE-B96. Outcomes included costs, life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), incremental net monetary benefits (INMBs), and incremental net health benefits (INHBs). Cost-effectiveness was assessed against willingness-to-pay (WTP) thresholds of $27,906\/QALY in China and $150,000\/QALY in the US. Deterministic and probabilistic sensitivity analyses, scenario analyses, and subgroup analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In China, pembrolizumab plus weekly paclitaxel increased costs from $31,241.22 to $127,168.48 and increased outcomes from 1.57 to 2.11 LYs and from 1.02 to 1.34 QALYs, yielding 0.54 additional LYs and 0.32 additional QALYs. The ICER was $295,671.88\/QALY, with an INMB of \u2212$86,873.48 and an INHB of \u22123.11 QALYs. In the US, costs increased from $199,488.96 to $451,893.63, and outcomes increased from 1.59 to 2.15 LYs and from 1.03 to 1.37 QALYs. The ICER was $746,255.61\/QALY, with an INMB of \u2212$201,670.44 and an INHB of \u22121.34 QALYs. Pembrolizumab cost and health-state utilities were the main ICER drivers. Probabilistic sensitivity analysis showed 0% cost-effectiveness probability at both WTP thresholds. Scenario and subgroup analyses confirmed the base-case findings. At current bevacizumab prices, pembrolizumab prices would need substantial reductions to meet country-specific WTP thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared with placebo plus weekly paclitaxel, pembrolizumab plus weekly paclitaxel improved survival and QALYs in patients with PD-L1\u2013positive platinum-resistant recurrent ovarian cancer but was unlikely to be cost-effective at current prices in either China or the US.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1926275","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:36:24Z","timestamp":1789968984000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-effectiveness of pembrolizumab plus weekly paclitaxel for PD-L1\u2013positive platinum-resistant recurrent ovarian cancer in the United States and China"],"prefix":"10.3389","volume":"17","author":[{"given":"Feng","family":"Xuan","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Zhuji Affiliated Hospital of Wenzhou Medical University","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoze","family":"Bian","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Zhuji Affiliated Hospital of Wenzhou Medical University","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minguang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Zhuji Affiliated Hospital of Wenzhou Medical University","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Zhuji Affiliated Hospital of Wenzhou Medical University","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guodong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Zhuji Affiliated Hospital of Wenzhou Medical University","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3312","DOI":"10.1200\/jco.2001.19.14.3312","article-title":"Recurrent epithelial ovarian carcinoma: a randomized phase III study of pegylated liposomal doxorubicin versus topotecan","volume":"19","author":"A N","year":"2001","journal-title":"J. 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