Sequential treatment approaches in the management of BRAF wild-type advanced melanoma: a cost-effectiveness analysis.
Immunotherapy
; 10(14): 1241-1252, 2018 10.
Article
en En
| MEDLINE
| ID: mdl-30175642
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.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Cutáneas
/
Simulación por Computador
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Ipilimumab
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Nivolumab
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Inmunoterapia
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Melanoma
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Anticuerpos Monoclonales
Tipo de estudio:
Health_economic_evaluation
Límite:
Humans
País como asunto:
America do norte
Idioma:
En
Año:
2018
Tipo del documento:
Article