Cost-effectiveness of pembrolizumab + chemotherapy versus chemotherapy and pembrolizumab monotherapy in first line treatment of NSCLC in the US - updated analyses with additional trial follow-up.

Journal of Medical Economics
Ralph InsingaYing Zhang

Abstract

Pembrolizumab + chemotherapy substantially extends life expectancy for metastatic non-small cell lung cancer (NSCLC) patients. Its cost-effectiveness (CE) was previously evaluated based on interim trial analyses (follow-up ∼1 year). The present analysis describes CE incorporating additional follow-up based on protocol-specified final trial analyses (1-1.5 years additional follow-up), from a US healthcare payer perspective. A partitioned survival model is used to compare pembrolizumab + chemotherapy vs chemotherapy using data from the KN189 (non-squamous patients) and KN407 (squamous patients) clinical trials. An indirect treatment comparison vs pembrolizumab monotherapy is made for patient subgroups with PD-L1 TPS ≥50% and 1-49% based on data from the KN024 and KN042 trials. Efficacy, treatment utilization, health utility, and safety data are derived from trials and projected over 20 years. Costs for drugs, non-drug disease management, and adverse events are also incorporated. Overall, versus chemotherapy alone, pembrolizumab + chemotherapy is projected to increase life expectancy by 1.12 years (3.35 vs 2.23) and 0.67 years (3.17 vs 2.50) in non-squamous and squamous patients, respectively. Resultant ICERs ($158,030/QALY and $1...Continue Reading

References

Jan 24, 2013·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Nicholas R Latimer
Dec 23, 2015·Journal of Comparative Effectiveness Research·Robert W Dubois
Dec 21, 2016·Bulletin of the World Health Organization·Melanie Y BertramSuzanne R Hill
Aug 24, 2018·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Hossein BorghaeiLeena Gandhi
Jan 9, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Martin ReckJulie R Brahmer
Jul 1, 2020·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Luis Paz-AresBalazs Halmos
Apr 25, 2021·Annals of Oncology : Official Journal of the European Society for Medical Oncology·D Rodríguez-AbreuM C Garassino

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