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Budget impact analysis of the novel PD-1 inhibitor toripalimab versus pembrolizumab in recurrent or metastatic nasopharyngeal carcinoma.
- Source :
-
Journal of medical economics [J Med Econ] 2024; Vol. 27 (sup3), pp. 9-23. Date of Electronic Publication: 2024 Aug 18. - Publication Year :
- 2024
-
Abstract
- Aim: To estimate the budget impact of adding a toripalimab regimen as a treatment option to the existing pembrolizumab regimen, both including gemcitabine and cisplatin, in untreated recurrent/metastatic nasopharyngeal carcinoma (R/M NPC) using the published wholesale acquisition cost (WAC) and average sales price (ASP).<br />Methods: Budget impact analysis comparing a treatment mix "without" versus "with" the toripalimab regimen in the US eligible annual incident R/M NPC population, a 3-year time horizon, toripalimab/pembrolizumab market splits of 60/40 (Y1) and 80/20 (Y2/3), and medication adjustments for discontinuation or progression. Cost inputs included drugs, administration, and adverse event (AE) management. The models were replicated for a hypothetical 1-million-member health plan in which costs per-member-per-month (PMPM) and per-member-per-year (PMPY) were estimated. One-way (OWSA) and probabilistic sensitivity analyses (PSA) as well as scenario analyses were performed.<br />Results: In the "without" scenario, the 3-year WAC-based costs for the pembrolizumab regimen total $1,449,695,333 ($1,305,632,448 for treatment and $144,062,885 for managing AEs). In the "with" scenario, total 3-year costs for pembrolizumab decline to $380,012,135 with toripalimab adding $885,505,900 ($779,206,567 for treatment and $106,299,333 for AE management). Annual net savings range from $46,526,152 in 2024 to $71,194,214 in 2026, for 3-year savings of $184,177,298. Associated net savings in a 1-million-member health plan are $543,068 over 3 years with savings of $0.045 PMPM and $0.543 PMPY. The ASP-based model shows similar patterns with 3-year net savings of $174,235,983 in the US incident population and savings of $0.043 PMPM and $0.514 PMPY in a 1-million-member health plan. The PSA support base case findings; OWSA and scenario analyses reveal how parameter variability impacts results.<br />Conclusion: Savings between $174 million and $184 million can be achieved from treating 60% of R/M NPC patients in year 1 and 80% in years 2 and 3 with the toripalimab regimen over a similar pembrolizumab regimen.
- Subjects :
- Humans
Neoplasm Recurrence, Local drug therapy
Cost-Benefit Analysis
Antineoplastic Combined Chemotherapy Protocols economics
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Antineoplastic Agents, Immunological economics
Antineoplastic Agents, Immunological therapeutic use
Immune Checkpoint Inhibitors therapeutic use
Immune Checkpoint Inhibitors economics
Deoxycytidine analogs & derivatives
Deoxycytidine therapeutic use
Deoxycytidine economics
Models, Econometric
Budgets
Gemcitabine
Neoplasm Metastasis
United States
Health Expenditures statistics & numerical data
Antibodies, Monoclonal, Humanized therapeutic use
Antibodies, Monoclonal, Humanized economics
Nasopharyngeal Carcinoma drug therapy
Nasopharyngeal Carcinoma economics
Nasopharyngeal Neoplasms drug therapy
Nasopharyngeal Neoplasms economics
Nasopharyngeal Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1941-837X
- Volume :
- 27
- Issue :
- sup3
- Database :
- MEDLINE
- Journal :
- Journal of medical economics
- Publication Type :
- Academic Journal
- Accession number :
- 39016811
- Full Text :
- https://doi.org/10.1080/13696998.2024.2379055