Clinical and economic outcomes associated with treatment sequences in patients with BRAF-mutant advanced melanoma.
Immunotherapy
; 11(4): 283-295, 2019 03.
Article
en En
| MEDLINE
| ID: mdl-30563395
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.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Cutáneas
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Protocolos de Quimioterapia Combinada Antineoplásica
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Modelos Económicos
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Costos y Análisis de Costo
/
Inmunoterapia
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Melanoma
/
Anticuerpos Monoclonales
Tipo de estudio:
Health_economic_evaluation
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Año:
2019
Tipo del documento:
Article