Katanyoo K.Chaikledkaew U.Chandeying N.Mahidol University2025-04-012025-04-012025-12-01Scientific Reports Vol.15 No.1 (2025)https://repository.li.mahidol.ac.th/handle/123456789/108587Bevacizumab (BEV) combined with standard chemotherapy with carboplatin and paclitaxel (CP) as the front-line treatment for newly diagnosed advanced-stage epithelial ovarian cancer (EOC) is a promising treatment option. In Thailand, combined BEV and CP for patients with high-risk EOC is not yet covered. This study aimed to explore the cost-effectiveness of combined BEV and CP for subgroups with high-risk EOC. Cost-utility analysis was conducted to compare the effectiveness of CP alone versus combined BEV and CP according to the Gynecologic Oncology Group-218 (GOG-218) and the Gynecologic Cancer Intergroup International Collaboration on Ovarian Neoplasms 7 (ICON-7) regimens in patients with EOC. The decision tree model and Markov model were applied, and incremental cost-effectiveness ratios (ICERs) were analyzed. Data on direct medical costs were obtained from cost databases in Thailand. Details about all clinical parameters and direct non-medical costs were obtained from published studies. Utility information was collected by interviewing patient subgroups with high-risk EOC. One-way and probabilistic sensitivity analyses were performed to evaluate parameter uncertainties. Based on the provider and societal perspectives, the ICERs of CP and the GOG-218 regimen were $31,266 and $31,966 per quality adjusted life year (QALY) gained, respectively. Meanwhile, the ICERs of CP and the ICON-7 regimen were $14,331 and $15,003 per QALY gained, respectively. The probabilities of cost-effectiveness for using BEV as the GOG-218 and ICON-7 regimens were 0% and 3%, respectively, based on the willingness-to-pay threshold in Thailand ($4,571 per QALY gained). The median progression-free survival of patients who received combined BEV and CP was the most important parameter leading to more benefit from using BEV. BEV as the GOG-218 or ICON-7 regimen may not be cost-effective for patient subgroups with high-risk EOC in Thailand. However, BEV as the ICON-7 regimen is more likely to be effective.MultidisciplinaryArticleSCOPUS10.1038/s41598-025-94455-72-s2.0-10500070734120452322