Ahmad Tarhini1, Agnes Benedict2, David McDermott3, Sumati Rao4, Apoorva Ambavane5, Komal Gupte-Singh4, Javier Sabater4, Corey Ritchings4, Valerie Aponte-Ribero5, Meredith M Regan6, Michael Atkins7. 1. Department of Hematology & Oncology, Cleveland Clinic, Taussig Cancer Center, Cleveland, OH, USA. 2. Modelling & Simulation (HEOR), Evidera, a wholly owned subsidiary of Pharmaceutical Product Development, LLC, Budapest, Hungary. 3. Biologic Therapy & Cutaneous Oncology Program, Beth Israel Deaconess Medical Center, Boston, MA, USA. 4. Health Economics Outcomes Research, Bristol-Myers Squibb, Princeton, NJ, USA. 5. Modeling & Simulation, Evidera, a wholly owned subsidiary of Pharmaceutical Product Development, LLC, London, UK. 6. Biostatistics & Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA. 7. Oncology, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA.
Abstract
AIM: To evaluate the cost-effectiveness of treatment sequences with checkpoint inhibitors in patients with BRAF wild-type melanoma. MATERIALS & METHODS: Using a discrete event simulation model, cost and health outcomes were estimated. Pooled data from CheckMate 067/069 trials were used to calculate survival outcomes including treatment-free interval extrapolated over a patient's lifetime. Costs accounted for treatment, administration, toxicity, and disease management. RESULTS: First-line anti-PD-1 + anti-CTLA-4 initiating sequences had the highest estimated mean survival gain (7.6-7.7 years), driven by a longer estimated mean treatment-free interval (5.3 years). Incremental costs per incremental quality-adjusted life year gained for anti-PD-1 + anti-CTLA-4 followed by chemotherapy were US$30,955 versus anti-PD-1 initiating sequences, within the willingness-to-pay threshold. CONCLUSION: Anti-PD-1 + anti-CTLA-4 initiating sequences for BRAF wild-type melanoma are cost-effective versus anti-PD-1.
AIM: To evaluate the cost-effectiveness of treatment sequences with checkpoint inhibitors in patients with BRAF wild-type melanoma. MATERIALS & METHODS: Using a discrete event simulation model, cost and health outcomes were estimated. Pooled data from CheckMate 067/069 trials were used to calculate survival outcomes including treatment-free interval extrapolated over a patient's lifetime. Costs accounted for treatment, administration, toxicity, and disease management. RESULTS: First-line anti-PD-1 + anti-CTLA-4 initiating sequences had the highest estimated mean survival gain (7.6-7.7 years), driven by a longer estimated mean treatment-free interval (5.3 years). Incremental costs per incremental quality-adjusted life year gained for anti-PD-1 + anti-CTLA-4 followed by chemotherapy were US$30,955 versus anti-PD-1 initiating sequences, within the willingness-to-pay threshold. CONCLUSION: Anti-PD-1 + anti-CTLA-4 initiating sequences for BRAF wild-type melanoma are cost-effective versus anti-PD-1.
Authors: Deborah A Marshall; Luiza R Grazziotin; Dean A Regier; Sarah Wordsworth; James Buchanan; Kathryn Phillips; Maarten Ijzerman Journal: Value Health Date: 2020-03-26 Impact factor: 5.725
Authors: Meredith M Regan; Lillian Werner; Sumati Rao; Komal Gupte-Singh; F Stephen Hodi; John M Kirkwood; Harriet M Kluger; James Larkin; Michael A Postow; Corey Ritchings; Mario Sznol; Ahmad A Tarhini; Jedd D Wolchok; Michael B Atkins; David F McDermott Journal: J Clin Oncol Date: 2019-09-09 Impact factor: 44.544