Liao W, Huang J, Hutton D, et al. - In the CELESTIAL trial for patients with advanced hepatocellular carcinoma (HCC), researchers examined the cost-efficiency of cabozantinib for sorafenib-resistant HCC from the payers’ perspectives of the US, UK, and China. In the base-case, treatment with cabozantinib enhanced efficacy by 0.13 QALYs, leading to an incremental cost-effectiveness ratio vs best supportive care of $833,497/QALY, $304,177/QALY, and $156,437/QALY in the US, in the UK, and in China, respectively. The model was most susceptible to hypotheses about transitions to progression with both cabozantinib and best supportive care, the utility related to being progression-free. These outcomes were powerful across a range of situations and sensitivity analyses, comprising deterministic and probabilistic analyses. Hence, for patients with sorafenib-resistant HCC, cabozantinib at its prevailing cost would not be a cost-efficient treatment option from the payer's point of view in the US, UK, or China. To reach conventional cost-efficacy thresholds, substantial discounts are required.