The cost-effectiveness of nivolumab monotherapy for the treatment of advanced melanoma patients in England

The European Journal of Health Economics - Tập 19 Số 8 - Trang 1163-1172 - 2018
Meng, Yang1, Hertel, Nadine2, Ellis, John2, Morais, Edith2, Johnson, Helen3, Philips, Zoe1, Roskell, Neil1, Walker, Andrew4, Lee, Dawn1
1BresMed Health Solutions, North Church House, Sheffield, UK
2Bristol-Myers Squibb Pharmaceuticals, Uxbridge, UK
3Helen Johnson Consulting Ltd, Welwyn Garden City, UK
4University of Glasgow, Glasgow, UK

Tóm tắt

Nivolumab was the first programmed death receptor 1 (PD-1) immune checkpoint inhibitor to demonstrate long-term survival benefit in a clinical trial setting for advanced melanoma patients. To evaluate the cost effectiveness of nivolumab monotherapy for the treatment of advanced melanoma patients in England. A Markov state-transition model was developed to estimate the lifetime costs and benefits of nivolumab versus ipilimumab and dacarbazine for BRAF mutation-negative patients and versus ipilimumab, dabrafenib, and vemurafenib for BRAF mutation-positive patients. Covariate-adjusted parametric curves for time to progression, pre-progression survival, and post-progression survival were fitted based on patient-level data from two trials and long-term ipilimumab survival data. Indirect treatment comparisons between nivolumab, ipilimumab, and dacarbazine were informed by these covariate-adjusted parametric curves, controlling for differences in patient characteristics. Kaplan–Meier data from the literature were digitised and used to fit progression-free and overall survival curves for dabrafenib and vemurafenib. Patient utilities and resource use data were based on trial data or the literature. Patients are assumed to receive nivolumab until there is no further clinical benefit, assumed to be the first of progressive disease, unacceptable toxicity, or 2 years of treatment. Nivolumab is the most cost-effective treatment option in BRAF mutation-negative and mutation-positive patients, with incremental cost-effectiveness ratios of £24,483 and £17,362 per quality-adjusted life year, respectively. The model results are most sensitive to assumptions regarding treatment duration for nivolumab and the parameters of the fitted parametric survival curves. Nivolumab is a cost-effective treatment for advanced melanoma patients in England.

Tài liệu tham khảo

citation_journal_title=Eur. J. Cancer; citation_title=Diagnosis and treatment of melanoma. European consensus-based interdisciplinary guideline—update 2012; citation_author=C Garbe, K Peris, A Hauschild; citation_volume=48; citation_publication_date=2012; citation_pages=2375-2390; citation_doi=10.1016/j.ejca.2012.06.013; citation_id=CR1 citation_journal_title=J. Clin. Oncol.; citation_title=Meta-analysis of Phase II cooperative group trials in metastatic stage IV melanoma to determine progression-free and overall survival benchmarks for future Phase II trials; citation_author=EL Korn, PY Liu, SJ Lee; citation_volume=26; citation_publication_date=2008; citation_pages=527-534; citation_doi=10.1200/JCO.2007.12.7837; citation_id=CR2 citation_journal_title=J. Clin. Oncol.; citation_title=Final version of 2009 AJCC melanoma staging and classification; citation_author=CM Balch, JE Gershenwald, SJ Soong; citation_volume=27; citation_publication_date=2009; citation_pages=6199-6206; citation_doi=10.1200/JCO.2009.23.4799; citation_id=CR3 citation_journal_title=Oncologist.; citation_title=Systematic review of medical treatment in melanoma: current status and future prospects; citation_author=C Garbe, TK Eigentler, U Keilholz; citation_volume=16; citation_publication_date=2011; citation_pages=5-24; citation_doi=10.1634/theoncologist.2010-0190; citation_id=CR4 citation_journal_title=Expert Rev. Anticancer Ther.; citation_title=Current systemic therapy for metastatic melanoma; citation_author=SS Agarwala; citation_volume=9; citation_publication_date=2009; citation_pages=587-595; citation_doi=10.1586/era.09.25; citation_id=CR5 citation_journal_title=Br. J. Dermatol.; citation_title=Treatment patterns, outcomes, and resource utilization of patients with metastatic melanoma in the U.K.: the MELODY study; citation_author=P Lorigan, M Marples, M Harries; citation_volume=170; citation_publication_date=2014; citation_pages=87-95; citation_doi=10.1111/bjd.12503; citation_id=CR6 Cancer Research UK (CRUK). Melanoma statistics and outlook. 2014 citation_journal_title=Nat. Rev. Clin. Oncol.; citation_title=The Society for Immunotherapy of Cancer consensus statement on tumour immunotherapy for the treatment of cutaneous melanoma; citation_author=HL Kaufman, JM Kirkwood, FS Hodi; citation_volume=10; citation_publication_date=2013; citation_pages=588-598; citation_doi=10.1038/nrclinonc.2013.153; citation_id=CR8 citation_journal_title=J. Clin. Oncol.; citation_title=Pooled analysis of long-term survival data from Phase II and Phase III trials of ipilimumab in unresectable or metastatic melanoma; citation_author=D Schadendorf, FS Hodi, C Robert; citation_volume=33; citation_publication_date=2015; citation_pages=1889-1894; citation_doi=10.1200/JCO.2014.56.2736; citation_id=CR9 citation_journal_title=N. Engl. J. Med.; citation_title=Improved survival with vemurafenib in melanoma with BRAF V600E mutation; citation_author=PB Chapman, A Hauschild, C Robert; citation_volume=364; citation_publication_date=2011; citation_pages=2507-2516; citation_doi=10.1056/NEJMoa1103782; citation_id=CR10 citation_journal_title=Lancet; citation_title=Dabrafenib in BRAF-mutated metastatic melanoma: a multicentre, open-label. Phase III randomised controlled trial; citation_author=A Hauschild, JJ Grob, LV Demidov; citation_volume=380; citation_publication_date=2012; citation_pages=358-365; citation_doi=10.1016/S0140-6736(12)60868-X; citation_id=CR11 citation_journal_title=N. Engl. J. Med.; citation_title=Survival in BRAF V600-mutant advanced melanoma treated with vemurafenib; citation_author=JA Sosman, KB Kim, L Schuchter; citation_volume=366; citation_publication_date=2012; citation_pages=707-714; citation_doi=10.1056/NEJMoa1112302; citation_id=CR12 citation_journal_title=Eur. J. Cancer; citation_title=Resistance to BRAF-targeted therapy in melanoma; citation_author=RJ Sullivan, KT Flaherty; citation_volume=49; citation_publication_date=2013; citation_pages=1297-1304; citation_doi=10.1016/j.ejca.2012.11.019; citation_id=CR13 citation_journal_title=Cancer Immunol. Res.; citation_title=In vitro characterization of the anti-PD-1 antibody nivolumab, BMS-936558, and in vivo toxicology in non-human primates; citation_author=C Wang, KB Thudium, M Han; citation_volume=2; citation_publication_date=2014; citation_pages=846-856; citation_doi=10.1158/2326-6066.CIR-14-0040; citation_id=CR14 National Institute for Health and Care Excellence (NICE). TA384:Nivolumab for treating advanced (unresectable or metastatic) melanoma. 2016 National Institute for Health and Care Excellence (NICE). TA357: Pembrolizumab for treating advanced melanoma after disease progression with ipilimumab. 2015 National Institute for Health and Care Excellence (NICE). TA366: Pembrolizumab for advanced melanoma not previously treated with ipilimumab. 2015 citation_journal_title=Health Qual Life Outcomes.; citation_title=Patient-reported utilities in advanced or metastatic melanoma, including analysis of utilities by time to death; citation_author=AJ Hatswell, B Pennington, L Pericleous; citation_volume=12; citation_publication_date=2014; citation_pages=140; citation_doi=10.1186/s12955-014-0140-1; citation_id=CR18 citation_journal_title=Value in Health; citation_title=Patient Reported Utilities In First-Line Advanced Or Metastatic Melanoma: Analysis Of Trial CA184-024; citation_author=J. Porter, D. Lee, N. Hertel, A.J. Hatswell; citation_volume=17; citation_issue=7; citation_publication_date=2014; citation_pages=A569; citation_doi=10.1016/j.jval.2014.08.1900; citation_id=CR19 citation_journal_title=J. Natl. Cancer Inst.; citation_title=Cost-utility analysis of short-versus long-course palliative radiotherapy in patients with non–small-cell lung cancer; citation_author=WB Hout, GW Kramer, EM Noordijk; citation_volume=98; citation_publication_date=2006; citation_pages=1786-1794; citation_doi=10.1093/jnci/djj496; citation_id=CR20 citation_journal_title=N. Engl. J. Med.; citation_title=Nivolumab in previously untreated melanoma without BRAF mutation; citation_author=C Robert, GV Long, B Brady; citation_volume=372; citation_publication_date=2015; citation_pages=320-330; citation_doi=10.1056/NEJMoa1412082; citation_id=CR21 citation_journal_title=N. Engl. J. Med.; citation_title=Improved survival with ipilimumab in patients with metastatic melanoma; citation_author=FS Hodi, SJ O’Day, DF McDermott; citation_volume=363; citation_publication_date=2010; citation_pages=711-723; citation_doi=10.1056/NEJMoa1003466; citation_id=CR22 citation_journal_title=Journal of Clinical Oncology; citation_title=Overall survival (OS) in the management of pretreated patients with unresectable stage III/IV melanoma: A systematic literature review and meta-analysis; citation_author=S. Kotapati, P. Dequen, M. Ouwens, M. van Baardewijk, R. A. Ibrahim, S. Wagner, J. P. Jansen; citation_volume=29; citation_issue=15_suppl; citation_publication_date=2011; citation_pages=8580-8580; citation_doi=10.1200/jco.2011.29.15_suppl.8580; citation_id=CR23 Wada R, Feng Y, Zhang N, et al. Meta-analysis of Kaplan-Meier overall survival curves from selected randomized controlled Phase II/III trials in advanced melanoma. Population Approach Group Europe Meeting. Athens: Greece. 2011 National Institute for Health and Care Excellence (NICE). TA319: Ipilimumab for previously untreated advanced (unresectable or metastatic) melanoma. 2014 citation_journal_title=PLoS ONE; citation_title=The predicted impact of ipilimumab usage on survival in previously treated advanced or metastatic melanoma in the UK; citation_author=J Larkin, AJ Hatswell, P Nathan; citation_volume=10; citation_publication_date=2015; citation_pages=e0145524; citation_doi=10.1371/journal.pone.0145524; citation_id=CR26 Latimer N. National Institute for Health an Clinical Excellence (NICE) DSU technical support document 14: Survival analysis for economic evaluations alongside clinical trials—Extrapolation with patient-level data. 2011 citation_journal_title=J. Clin. Oncol.; citation_title=Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma; citation_author=CM Balch, AC Buzaid, SJ Soong; citation_volume=19; citation_publication_date=2001; citation_pages=3635-3648; citation_doi=10.1200/JCO.2001.19.16.3635; citation_id=CR28 Office for National Statistics (ONS). National Life Tables, England 2011–2013. 2014 Oxford Outcomes. Advanced melanoma resource use and costs in Europe: final report. Data on File. 2011 citation_journal_title=Br. J. Cancer; citation_title=Societal preference values for advanced melanoma health states in the United Kingdom and Australia; citation_author=KM Beusterien, SM Szabo, S Kotapati; citation_volume=101; citation_publication_date=2009; citation_pages=387-389; citation_doi=10.1038/sj.bjc.6605187; citation_id=CR31 Monthly Index of Medical Specialities (MIMS). 2016 Department of Health. Drugs and pharmaceutical electronic market information (eMit). 2016 Department of Health. NHS reference costs 2014–15. 2015 National Institute for Health and Care Excellence (NICE). TA268: Melanoma (stage III or IV)—ipilimumab: guidance. 2012 Hodi S, Kluger H, Sznol M. Durable, long-term survival in previously treated patients with advanced melanoma who received nivolumab monotherapy in a phase I trial. American Association for Cancer Research (AACR) Annual Meeting. New Orleans: USA. 2016 citation_journal_title=Value Health J Int Soc Pharmacoecon Outcomes Res; citation_title=Partitioned survival versus state transition modeling in oncology: a case study with nivolumab in advanced melanoma; citation_author=A Briggs, T Baker, I Gilloteau; citation_volume=18; citation_publication_date=2015; citation_pages=A338; citation_doi=10.1016/j.jval.2015.09.130; citation_id=CR37