Ahmad Tarhini1, David McDermott2, Apoorva Ambavane3, Komal Gupte-Singh4, Valerie Aponte-Ribero3, Corey Ritchings4, Agnes Benedict5, Sumati Rao4, Meredith M Regan6, Michael Atkins7. 1. Department of Hematology & Oncology, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, 44106, USA. 2. Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. 3. Evidera, Inc., London, UK. 4. Bristol-Myers Squibb, Princeton, NJ, 08648, USA. 5. Evidera, Inc., Budapest, Hungary. 6. Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02215, USA. 7. Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, 20007, USA.
Abstract
AIM: The cost-effectiveness of treatment sequences in BRAF-mutant advanced melanoma. MATERIALS & METHODS: A discrete event simulation model was developed to estimate total costs and health outcomes over a patient's lifetime (30 years). Efficacy was based on the CheckMate 067/069 trials and a matching-adjusted-indirect comparison between immuno-oncology and targeted therapies. Safety, cost (in US dollars; US third-party payer perspective) and health-related quality-of-life inputs were based on published literature. RESULTS: Estimated survival gain was higher for sequences initiating with anti-PD-1 + anti-CTLA-4 than for anti-PD-1 monotherapy or BRAF+MEK inhibitors. The incremental cost-effectiveness ratio per QALY gained for first-line anti-PD-1 + anti-CTLA-4 was US$54,273 versus first-line anti-PD-1 and $79,124 versus first-line BRAF+MEK inhibitors. CONCLUSION: Initiating treatment with anti-PD-1 + anti-CTLA-4 was more cost-effective than initiation with anti-PD-1 monotherapy or BRAF+MEK inhibitors.
AIM: The cost-effectiveness of treatment sequences in BRAF-mutant advanced melanoma. MATERIALS & METHODS: A discrete event simulation model was developed to estimate total costs and health outcomes over a patient's lifetime (30 years). Efficacy was based on the CheckMate 067/069 trials and a matching-adjusted-indirect comparison between immuno-oncology and targeted therapies. Safety, cost (in US dollars; US third-party payer perspective) and health-related quality-of-life inputs were based on published literature. RESULTS: Estimated survival gain was higher for sequences initiating with anti-PD-1 + anti-CTLA-4 than for anti-PD-1 monotherapy or BRAF+MEK inhibitors. The incremental cost-effectiveness ratio per QALY gained for first-line anti-PD-1 + anti-CTLA-4 was US$54,273 versus first-line anti-PD-1 and $79,124 versus first-line BRAF+MEK inhibitors. CONCLUSION: Initiating treatment with anti-PD-1 + anti-CTLA-4 was more cost-effective than initiation with anti-PD-1 monotherapy or BRAF+MEK inhibitors.
Authors: Paweł Rogala; Anna M Czarnecka; Bożena Cybulska-Stopa; Krzysztof Ostaszewski; Karolina Piejko; Marcin Ziętek; Robert Dziura; Ewa Rutkowska; Łukasz Galus; Natasza Kempa-Kamińska; Jacek Calik; Agata Sałek-Zań; Tomasz Zemełka; Wiesław Bal; Agnieszka Kamycka; Tomasz Świtaj; Grażyna Kamińska-Winciorek; Rafał Suwiński; Jacek Mackiewicz; Piotr Rutkowski Journal: J Clin Med Date: 2022-04-17 Impact factor: 4.964
Authors: Olivier Michielin; Michael B Atkins; Henry B Koon; Reinhard Dummer; Paolo Antonio Ascierto Journal: J Immunother Cancer Date: 2020-10 Impact factor: 13.751
Authors: Geoffrey T Gibney; Jacob Zaemes; Shelly Shand; Neil J Shah; David Swoboda; Kellie Gardner; Arash Radfar; Vesna Petronic-Rosic; Michael J Reilly; Waddah B Al-Refaie; Suthee Rapisuwon; Michael B Atkins Journal: J Immunother Cancer Date: 2021-10 Impact factor: 13.751
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