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J.P. Lima
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P2.07 - Immunology and Immunotherapy (ID 708)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Immunology and Immunotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.07-054 - Cost-Effectiveness of Pembrolizumab as First-Line Therapy for Advanced Non-Small Cell Lung Cancer (ID 7510)
09:30 - 09:30 | Author(s): J.P. Lima
- Abstract
Background:
Immunotherapy is changing the therapeutic perspective and expectations for solid tumors and constitutes a major therapeutic advance for advanced non-small cell lung cancer (NSCLC). We assessed the cost-effectiveness of pembrolizumab (anti-PD-1 antibody) as compared to platinum-doublet chemotherapy as first-line therapy for advanced NSCLC.
Method:
We developed a Bayesian Markov model of disease states with a 5-year horizon. We retrieved survival, progression, and safety data comparing pembrolizumab to contemporaneous platinum-doublet chemotherapy as first-line therapy for PD-L1 expression equal to or greater than 50%, EGFR non-mutated, ALK non-translocated lung carcinoma patients. Published estimated US and UK costs were applied to inform the incremental cost-effectiveness ratio (ICER). We estimated costs in USD and summarized effectiveness as discounted quality-adjusted life-years (QALYs).
Result:
Patients treated with pembrolizumab accumulated 0.65 QALYs (95% credible interval [95% CrI] 0.5-0.91) as compared to 0.19 QALYs (95% CrI 0.16-0.22) to 0.32 QALYs (95% CrI 0.27-0.37) for those treated with platinum-doublet chemotherapy. From a current US cost perspective, ICERs varied from $173,000 (95% CrI $163,000-$183,000) to $201,000 (95% CrI $182,000-232,000) for one end-of-life (EoL) adjusted QALY, while from a British National Health System (NHS) perspective, ICERs varied from $154,000 (95% CrI $144,000-$166,000) to $193,000 (95% CrI $165,000-$248,000) per EoL adjusted QALY gained.
Conclusion:
At current price, pembrolizumab is not cost effective considering the usual NICE threshold in the UK. In the US, these numbers would be considered cost-effective according to the WHO definition.
