Cost-Effectiveness Analysis of Nivolumab Plus Ipilimumab for Advanced Non-Small-Cell Lung Cancer
Objective: This study evaluated the cost-effectiveness of nivolumab plus ipilimumab vs. chemotherapy in the first-line setting for patients with advanced non-small-cell lung cancer (NSCLC) from the US payer perspective.Materials and methods: A Markov model wasdeveloped to evaluate the cost and effec...
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Frontiers Media S.A.
2021-08-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2021.580459/full |
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| author | Xiaomin Wan Xiaohui Zeng Liubao Peng Ye Peng Qiao Liu Lidan Yi Xia Luo Qijian Deng Qijian Deng Chongqing Tan |
| author_facet | Xiaomin Wan Xiaohui Zeng Liubao Peng Ye Peng Qiao Liu Lidan Yi Xia Luo Qijian Deng Qijian Deng Chongqing Tan |
| author_sort | Xiaomin Wan |
| collection | DOAJ |
| description | Objective: This study evaluated the cost-effectiveness of nivolumab plus ipilimumab vs. chemotherapy in the first-line setting for patients with advanced non-small-cell lung cancer (NSCLC) from the US payer perspective.Materials and methods: A Markov model wasdeveloped to evaluate the cost and effectiveness of nivolumab plus ipilimumab vs. chemotherapy in the first-line treatment of advanced NSCLC. The survival benefits of nivolumab plus ipilimumab were based on the results of the CheckMate 227 trial. The main endpoints of the model were cost, life-years (LYs), quality-adjusted LYs (QALYs), and incremental cost-effectiveness ratio (ICER). Univariable and probabilistic sensitivity analyses were conducted to assess model uncertainty. Additonal subgroup analyses were also performed.Results: nivolumab plus ipilimumab produced a gain of 0.62 QALYs, at a cost of $104238 per QALY. The variables that had the greatest influence on the ICER were body weight and overall survival (OS) hazard ratio (HR). The probability of nivolumab plus ipilimumab being cost-effectiveness compared to chemotherapy is 50.7 and 66.2% when the willingness-to-pay (WTP) value is $ 100,000 and $ 150,000 per QALY. The results of subgroup analyses showed the ICER remained below $150,000/QALY regardless of the PD-L1 expression level.Conclusions: nivolumab plus ipilimumab was estimated to be cost-effective compared with chemotherapy for patients with advanced NSCLC at a WTP threshold from 100,000/QALY to 150,000/QALY. |
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| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-16T12:08:40Z |
| publishDate | 2021-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pharmacology |
| spelling | doaj.art-5d39d3f9015d4c80be89f746e375ed642022-12-21T22:32:14ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122021-08-011210.3389/fphar.2021.580459580459Cost-Effectiveness Analysis of Nivolumab Plus Ipilimumab for Advanced Non-Small-Cell Lung CancerXiaomin Wan0Xiaohui Zeng1Liubao Peng2Ye Peng3Qiao Liu4Lidan Yi5Xia Luo6Qijian Deng7Qijian Deng8Chongqing Tan9Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, ChinaPET-CT Center, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, ChinaHunan Key Laboratory of Psychiatry and Mental Health, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Mental Health Institute of the Second Xiangya Hospital, Chinese National Technology Institute on Mental Disorders, Central South University, Changsha, ChinaDepartment of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, ChinaObjective: This study evaluated the cost-effectiveness of nivolumab plus ipilimumab vs. chemotherapy in the first-line setting for patients with advanced non-small-cell lung cancer (NSCLC) from the US payer perspective.Materials and methods: A Markov model wasdeveloped to evaluate the cost and effectiveness of nivolumab plus ipilimumab vs. chemotherapy in the first-line treatment of advanced NSCLC. The survival benefits of nivolumab plus ipilimumab were based on the results of the CheckMate 227 trial. The main endpoints of the model were cost, life-years (LYs), quality-adjusted LYs (QALYs), and incremental cost-effectiveness ratio (ICER). Univariable and probabilistic sensitivity analyses were conducted to assess model uncertainty. Additonal subgroup analyses were also performed.Results: nivolumab plus ipilimumab produced a gain of 0.62 QALYs, at a cost of $104238 per QALY. The variables that had the greatest influence on the ICER were body weight and overall survival (OS) hazard ratio (HR). The probability of nivolumab plus ipilimumab being cost-effectiveness compared to chemotherapy is 50.7 and 66.2% when the willingness-to-pay (WTP) value is $ 100,000 and $ 150,000 per QALY. The results of subgroup analyses showed the ICER remained below $150,000/QALY regardless of the PD-L1 expression level.Conclusions: nivolumab plus ipilimumab was estimated to be cost-effective compared with chemotherapy for patients with advanced NSCLC at a WTP threshold from 100,000/QALY to 150,000/QALY.https://www.frontiersin.org/articles/10.3389/fphar.2021.580459/fullnivolumab plus ipilimumabchemotherapycost-effectivenessnon-small cell lung cancerMarkov model |
| spellingShingle | Xiaomin Wan Xiaohui Zeng Liubao Peng Ye Peng Qiao Liu Lidan Yi Xia Luo Qijian Deng Qijian Deng Chongqing Tan Cost-Effectiveness Analysis of Nivolumab Plus Ipilimumab for Advanced Non-Small-Cell Lung Cancer Frontiers in Pharmacology nivolumab plus ipilimumab chemotherapy cost-effectiveness non-small cell lung cancer Markov model |
| title | Cost-Effectiveness Analysis of Nivolumab Plus Ipilimumab for Advanced Non-Small-Cell Lung Cancer |
| title_full | Cost-Effectiveness Analysis of Nivolumab Plus Ipilimumab for Advanced Non-Small-Cell Lung Cancer |
| title_fullStr | Cost-Effectiveness Analysis of Nivolumab Plus Ipilimumab for Advanced Non-Small-Cell Lung Cancer |
| title_full_unstemmed | Cost-Effectiveness Analysis of Nivolumab Plus Ipilimumab for Advanced Non-Small-Cell Lung Cancer |
| title_short | Cost-Effectiveness Analysis of Nivolumab Plus Ipilimumab for Advanced Non-Small-Cell Lung Cancer |
| title_sort | cost effectiveness analysis of nivolumab plus ipilimumab for advanced non small cell lung cancer |
| topic | nivolumab plus ipilimumab chemotherapy cost-effectiveness non-small cell lung cancer Markov model |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2021.580459/full |
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