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Cost-Utility of Nivolumab Plus Ipilimumab in First-Line Treatment of Advanced Melanoma in the United States: An Analysis Using Long-Term Overall Survival Data from Checkmate 067.
Baker, Timothy; Johnson, Helen; Kotapati, Srividya; Moshyk, Andriy; Hamilton, Melissa; Kurt, Murat; Paly, Victoria Federico.
Affiliation
  • Baker T; Global Health Economics, Outcomes Research and Epidemiology, ICON plc, ICON Clinical Research, 4131 Parklake Ave., Suite 600, Raleigh, NC, 27612, USA. Timothy.Baker@iconplc.com.
  • Johnson H; Bristol Myers Squibb, Uxbridge, UK.
  • Kotapati S; Bristol Myers Squibb, Princeton, NJ, USA.
  • Moshyk A; Bristol Myers Squibb, Princeton, NJ, USA.
  • Hamilton M; Bristol Myers Squibb, Princeton, NJ, USA.
  • Kurt M; Bristol Myers Squibb, Princeton, NJ, USA.
  • Paly VF; Global Health Economics, Outcomes Research and Epidemiology, ICON plc, ICON Clinical Research, 731Arbor Way, Suite 100, Blue Bell, PA, 19422, USA.
Pharmacoecon Open ; 6(5): 697-710, 2022 Sep.
Article in En | MEDLINE | ID: mdl-36006606
OBJECTIVE: The aim of this study was to evaluate the cost-utility of nivolumab plus ipilimumab (NIVO + IPI) versus other first-line therapies for advanced melanoma in the United States (US) from the third-party payer perspective. METHODS: This analysis estimated total expected life-years (LYs), quality-adjusted LYs (QALYs), and costs for first-line treatments of advanced melanoma during a 30-year time horizon using indirect treatment comparisons based on time-varying hazard ratios (HRs) and a three-state partitioned survival model. Overall survival (OS) and progression-free survival reference curves were extrapolated based on 5-year follow-up from the phase III Checkmate 067 trial (NCT01844505). Comparators of NIVO + IPI were NIVO, IPI, pembrolizumab, dabrafenib plus trametinib, encorafenib plus binimetinib (ENCO + BINI), and vemurafenib plus cobimetinib. Drug acquisition costs, treatment administration costs, follow-up time, subsequent therapy data, and adverse event frequencies were obtained from published sources. Utility weights were estimated from Checkmate 067, which compared NIVO + IPI or NIVO monotherapy with IPI monotherapy as first-line therapy in advanced melanoma. A 3% annual discount rate was applied to costs and outcomes. Sensitivity scenarios for BRAF-mutant subgroups were conducted. RESULTS: NIVO + IPI was estimated to generate the longest OS and the highest total costs versus all comparators, accruing 6.99 LYs, 5.70 QALYs, and $469,469 over the 30-year time horizon. The incremental cost utility of NIVO + IPI versus comparators ranged from $2130 per QALY (versus ENCO + BINI) to $76,169 per QALY (versus NIVO). In all base-case and most sensitivity analyses, the incremental cost-utility ratios for NIVO + IPI were below $100,000 per QALY. CONCLUSIONS: NIVO + IPI is estimated to be a life-extending and cost-effective treatment versus other therapies in the US, with base-case incremental cost-utility ratios below $100,000 per QALY.

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Health_economic_evaluation Aspects: Patient_preference Language: En Journal: Pharmacoecon Open Year: 2022 Document type: Article Affiliation country: United States Country of publication: Switzerland

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Health_economic_evaluation Aspects: Patient_preference Language: En Journal: Pharmacoecon Open Year: 2022 Document type: Article Affiliation country: United States Country of publication: Switzerland