Economic value of finotonlimab plus bevacizumab versus sorafenib for first-line treatment of unresectable hepatocellular carcinoma in China and the United States

Why clinicians should know about it

• Picked for Hepatology (top studies of the week, 2 August 2026).

Abstract

BACKGROUND: Finotonlimab combined with bevacizumab demonstrated superior progression-free survival and overall survival compared with sorafenib in patients with unresectable hepatocellular carcinoma. However, its economic value in different healthcare systems has not been fully characterized. This study evaluated the cost-effectiveness of finotonlimab plus bevacizumab from the perspectives of U.S. payers and the Chinese healthcare system. A Markov state-transition model was constructed using clinical efficacy data from a phase 3 randomized controlled trial. METHODS: Health state utilities were obtained directly from trial data, and cost inputs were derived from published sources and country-specific charge databases. The outcomes included quality-adjusted life years (QALYs), incremental cost-effectiveness ratios (ICERs), incremental net health benefits (INHBs), and incremental net monetary benefits (INMBs). Scenario analyses, deterministic and probabilistic sensitivity analyses, and price simulations were performed to assess the robustness and cost-effectiveness across predefined willingness-to-pay (WTP) thresholds. RESULTS: In the base-case analysis, the ICER of finotonlimab plus bevacizumab compared with sorafenib was $27,505.33 per QALY in China and $138,055.71 per QALY in the U.S., both below the corresponding WTP thresholds of $40,354.27 and $150,000 per QALY, respectively. The associated INHBs were 0.26 QALYs in China and 0.07 QALYs in the U.S., with INMBs of $10,523.82 and $10,684.73, respectively. Probabilistic sensitivity analysis indicated that combination therapy was cost-effective in 91.43% of simulations in China and 58.33% in the United States. Price simulation analyses suggested that finotonlimab would remain cost-effective in the U.S. setting when priced below $9,157.84 per 200 mg. CONCLUSION: From both Chinese and U.S. payer perspectives, finotonlimab plus bevacizumab represents a cost-effective first-line treatment strategy for unresectable hepatocellular carcinoma. These findings offer quantitative support for pricing and reimbursement decisions related to this emerging immunotherapy combination targeted therapy.

Abstract as published, via PubMed.