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Effectiveness and cost-effectiveness of pembrolizumab in persistent, recurrent, or metastatic cervical cancer with PD-L1 CPS 1-10: secondary analysis of KEYNOTE-826 using innovative KMSubtraction.

Created on 16 Jun 2026

Authors

Jin Zhou, Jiaqin Cai, Lirong Zhang, Yixiao Zhu, Li Lin, Hong Sun, Xiaoxia Wei

Published in

Expert review of pharmacoeconomics & outcomes research. Jun 16, 2026. Epub Jun 16, 2026.

Abstract

To evaluate the effectiveness and cost-effectiveness of pembrolizumab combined with chemotherapy and anti-angiogenesis treatment for PD-L1 CPS 1-10 cervical cancer (CC) patients from the perspective of US healthcare payers.
KM curves for the CPS 1-10 subgroup were derived using the KMSubtraction workflow to reconstruct individual patient data, with analysis based on restricted mean survival time. A partitioned survival model (PFS, PD, death) was used for cost-effectiveness analysis, applying a $150,000 per QALY willingness-to-pay threshold.
Pembrolizumab plus chemotherapy significantly improved PFS (RMST difference 5.06 months) and OS (RMST difference 5.84 months) versus placebo. The treatment increased QALYs by 1.17 at an additional cost of $297,505,yielding an ICER of 254,262 $/QALY. A threshold analysis indicated that an effective pembrolizumab price of $25.80 per mg would be required for the regimen to meet the $150,000/QALY threshold. Sensitivity analysis identified drug prices, health state utilities, and discount rates as key influencing factors.
Pembrolizumab+chemotherapy significantly improved PFS and OS in PD-L1 CPS 1-10 CC patients, with higher mean RMST than the placebo group. However, it is not cost-effective at current prices, but reducing pembrolizumab's price could improve its cost-effectiveness.

PMID:
42301432
Bibliographic data and abstract were imported from PubMed on 16 Jun 2026.

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