Cost-effectiveness of perioperative durvalumab plus neoadjuvant chemotherapy for muscle invasive bladder cancer in the United States

Background: The management of muscle-invasive bladder cancer (MIBC) remains challenging. The phase III NIAGARA trial showed that adding durvalumab to neoadjuvant chemotherapy significantly enhances event-free and overall survival for MIBC patients. However, due to the high cost of durvalumab, assess...

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Main Authors: Caicong You, Jiahao Zhang, Jianying Lei, Wu Fu, Maobai Liu, Hongfu Cai, Bin Zheng, Na Li
Format: Article
Language:English
Published: SAGE Publishing 2025-07-01
Series:Therapeutic Advances in Medical Oncology
Online Access:https://doi.org/10.1177/17588359251357519
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author Caicong You
Jiahao Zhang
Jianying Lei
Wu Fu
Maobai Liu
Hongfu Cai
Bin Zheng
Na Li
author_facet Caicong You
Jiahao Zhang
Jianying Lei
Wu Fu
Maobai Liu
Hongfu Cai
Bin Zheng
Na Li
author_sort Caicong You
collection DOAJ
description Background: The management of muscle-invasive bladder cancer (MIBC) remains challenging. The phase III NIAGARA trial showed that adding durvalumab to neoadjuvant chemotherapy significantly enhances event-free and overall survival for MIBC patients. However, due to the high cost of durvalumab, assessing its cost-effectiveness is crucial. Objective: To compare the cost-effectiveness of durvalumab with neoadjuvant chemotherapy versus neoadjuvant chemotherapy alone in operable MIBC, from the perspective of U.S. healthcare payers. Design: A model-based pharmacoeconomic evaluation. Method: A Markov model was constructed using data from the NIAGARA trial. Costs and utility were sourced from public databases and literature. Total costs, life-years, quality-adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER) were evaluated. Sensitivity analysis assessed model robustness. Results: Compared to neoadjuvant chemotherapy alone, the combination of durvalumab with neoadjuvant chemotherapy results in an additional 0.68 QALY, with an incremental cost of $86,485.19. The ICER per QALY is $93,693.79. Sensitivity analysis demonstrated the robustness of the model. Conclusion: From the perspective of U.S. payers, durvalumab combined with neoadjuvant chemotherapy is a cost-effective strategy compared to chemotherapy alone for treating operable MIBC.
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spelling doaj-art-7f63be1afbba40a3be1f81d06f5d836c2025-07-29T15:03:35ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592025-07-011710.1177/17588359251357519Cost-effectiveness of perioperative durvalumab plus neoadjuvant chemotherapy for muscle invasive bladder cancer in the United StatesCaicong YouJiahao ZhangJianying LeiWu FuMaobai LiuHongfu CaiBin ZhengNa LiBackground: The management of muscle-invasive bladder cancer (MIBC) remains challenging. The phase III NIAGARA trial showed that adding durvalumab to neoadjuvant chemotherapy significantly enhances event-free and overall survival for MIBC patients. However, due to the high cost of durvalumab, assessing its cost-effectiveness is crucial. Objective: To compare the cost-effectiveness of durvalumab with neoadjuvant chemotherapy versus neoadjuvant chemotherapy alone in operable MIBC, from the perspective of U.S. healthcare payers. Design: A model-based pharmacoeconomic evaluation. Method: A Markov model was constructed using data from the NIAGARA trial. Costs and utility were sourced from public databases and literature. Total costs, life-years, quality-adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER) were evaluated. Sensitivity analysis assessed model robustness. Results: Compared to neoadjuvant chemotherapy alone, the combination of durvalumab with neoadjuvant chemotherapy results in an additional 0.68 QALY, with an incremental cost of $86,485.19. The ICER per QALY is $93,693.79. Sensitivity analysis demonstrated the robustness of the model. Conclusion: From the perspective of U.S. payers, durvalumab combined with neoadjuvant chemotherapy is a cost-effective strategy compared to chemotherapy alone for treating operable MIBC.https://doi.org/10.1177/17588359251357519
spellingShingle Caicong You
Jiahao Zhang
Jianying Lei
Wu Fu
Maobai Liu
Hongfu Cai
Bin Zheng
Na Li
Cost-effectiveness of perioperative durvalumab plus neoadjuvant chemotherapy for muscle invasive bladder cancer in the United States
Therapeutic Advances in Medical Oncology
title Cost-effectiveness of perioperative durvalumab plus neoadjuvant chemotherapy for muscle invasive bladder cancer in the United States
title_full Cost-effectiveness of perioperative durvalumab plus neoadjuvant chemotherapy for muscle invasive bladder cancer in the United States
title_fullStr Cost-effectiveness of perioperative durvalumab plus neoadjuvant chemotherapy for muscle invasive bladder cancer in the United States
title_full_unstemmed Cost-effectiveness of perioperative durvalumab plus neoadjuvant chemotherapy for muscle invasive bladder cancer in the United States
title_short Cost-effectiveness of perioperative durvalumab plus neoadjuvant chemotherapy for muscle invasive bladder cancer in the United States
title_sort cost effectiveness of perioperative durvalumab plus neoadjuvant chemotherapy for muscle invasive bladder cancer in the united states
url https://doi.org/10.1177/17588359251357519
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