Cost-effectiveness of pembrolizumab in combination with chemotherapy versus chemotherapy and pembrolizumab monotherapy in the first-line treatment of squamous non-small-cell lung cancer in the US

Objective: To describe the cost-effectiveness of pembrolizumab plus chemotherapy (carboplatin and paclitaxel or nab-paclitaxel; P + C) in metastatic, squamous, non-small-cell lung cancer (NSCLC) patients in the US. Methods: A model comparing P + C versus C alone is developed utilizing partitioned su...

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Bibliographic Details
Published in:Current medical research and opinion 2019-07, Vol.35 (7), p.1241-1256
Main Authors: Insinga, Ralph P., Vanness, David J., Feliciano, Josephine L., Vandormael, Kristel, Traore, Sory, Ejzykowicz, Flavia, Burke, Thomas
Format: Article
Language:English
Subjects:
Albumins - administration & dosage
Antibodies, Monoclonal, Humanized - administration & dosage
B7-H1 Antigen - metabolism
Carboplatin - administration & dosage
Carcinoma, Non-Small-Cell Lung - drug therapy
Carcinoma, Squamous Cell - drug therapy
chemotherapy
Cost-Benefit Analysis
cost-effectiveness
Humans
Lung cancer
Lung Neoplasms - drug therapy
Paclitaxel - administration & dosage
pembrolizumab
Quality-Adjusted Life Years
Survival Analysis
United States
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Summary:Objective: To describe the cost-effectiveness of pembrolizumab plus chemotherapy (carboplatin and paclitaxel or nab-paclitaxel; P + C) in metastatic, squamous, non-small-cell lung cancer (NSCLC) patients in the US. Methods: A model comparing P + C versus C alone is developed utilizing partitioned survival analysis. Primary clinical efficacy, treatment utilization, health utility and safety data are derived from the KEYNOTE-407 trial and projected over 20 years. Costs for drugs and non-drug disease management are also incorporated. Additionally, the cost-effectiveness of P + C vs. pembrolizumab monotherapy (P) is evaluated via an indirect treatment comparison, for patient subgroups with PD-L1 Tumor Proportion Score (TPS) ≥ 50% and 1-49%. Results: Overall, P + C is projected to increase life expectancy by 1.95 years vs. C (3.86 versus 1.91). The resultant ICER is $86,293/QALY. In patients with PD-L1 ≥ 50%, 1-49% and
ISSN:0300-7995
1473-4877
DOI:10.1080/03007995.2019.1571297