Evidence map›Paper›PMID 41769117›Full record

ArticleFrontiers in public health2026

First-line enfortumab vedotin-pembrolizumab versus nivolumab plus gemcitabine-cisplatin in metastatic urothelial cancer: a cost-effectiveness study.

Haojie Ying, Bin Fu

Abstract readComparative Study
In one paragraph

Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Haojie YingThe Fourth School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Bin FuInstitute of Digital Traditional Chinese Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Recent phase III programs, EV-302 and CheckMate-901, showed that enfortumab vedotin plus pembrolizumab (EV + P) and nivolumab with gemcitabine-cisplatin (N + GC) deliver superior clinical outcomes when used as initial therapy for advanced urothelial cancer. What remains uncertain is their relative economic value when assessed under Chinese and US payer conditions. To address this gap, we compared the value for money of EV + P versus N + GC as first-line management for la/mUC from the perspectives of healthcare payers in China and the US. Methods: We performed a model-based economic evaluation using a time-dependent state-transition framework implemented in TreeAge Pro (2022). Health benefits were measured as quality-adjusted life-years (QALYs) derived from health-state utilities, and comparative value was expressed as incremental cost-effectiveness ratios (ICER). The robustness of the model was assessed through one-way sensitivity analysis (OWSA) to evaluate the impact of key parameter uncertainties. Results: In the US, EV + P cost $1,863,624.32 and provided 3.34 QALYs, while N + GC cost $881,979.07 for 2.36 QALYs, resulting in an ICER of $1,001,626.19 per QALY, exceeding the $150,000/QALY threshold. In China, EV + P cost $485,374.69 and provided 2.95 QALYs, compared to $203,811.61 for 2.15 QALYs with N + GC, yielding an ICER of $351,960.68/QALY, above the $40,451.64/QALY threshold. Therefore, N + GC is the more cost-effective first-line strategy in both countries. Conclusion: Under current pricing and reimbursement assumptions, N + GC is economically preferable to EV + P as a first-line strategy for la/mUC in both the US and China. EV + P may warrant consideration only in tightly selected scenarios or with substantial coordinated price reductions and policy changes. Meanwhile, it should be noted that due to the inherent limitations of the indirect comparison method between drugs, the conclusions of this study should be regarded as exploratory analysis results.

Indexed as

Antibodies, MonoclonalAntibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsCisplatinDeoxycytidineNivolumabUrologic NeoplasmsAntineoplastic Agents, ImmunologicalChinaCost-Benefit AnalysisCost-Effectiveness AnalysisGemcitabineHumansQuality-Adjusted Life YearsUnited StatesAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalCisplatinDeoxycytidineenfortumab vedotinGemcitabineNivolumabpembrolizumabcisplatincost-effectivenessenfortumab vedotingemcitabinemetastatic urothelial carcinomanivolumabpembrolizumab

Identifiers

PMID41769117
PMCPMC12935998

What Socratic holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.