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Clinical and economic outcomes associated with treatment sequences in patients with BRAF-mutant advanced melanoma
- Source :
- Immunotherapy. 11:283-295
- Publication Year :
- 2019
- Publisher :
- Future Medicine Ltd, 2019.
-
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.
- Subjects :
- Proto-Oncogene Proteins B-raf
0301 basic medicine
Oncology
medicine.medical_specialty
Skin Neoplasms
Cost-Benefit Analysis
Immune checkpoint inhibitors
Programmed Cell Death 1 Receptor
Immunology
Health outcomes
03 medical and health sciences
0302 clinical medicine
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Humans
Immunology and Allergy
Medicine
CTLA-4 Antigen
In patient
Melanoma
Protein Kinase Inhibitors
Neoplasm Staging
Advanced melanoma
business.industry
Antibodies, Monoclonal
Survival Analysis
Models, Economic
Treatment Outcome
030104 developmental biology
030220 oncology & carcinogenesis
Costs and Cost Analysis
Quality of Life
Immunotherapy
business
Subjects
Details
- ISSN :
- 17507448 and 1750743X
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Immunotherapy
- Accession number :
- edsair.doi.dedup.....17947ee449b31d337aaabbf475c25534