Clinical and Economic Outcomes Associated with Treatment Sequences In Patients With BRAF-Mutant Advanced Melanoma
A Tarhini, D McDermott, A Ambavane… - …, 2019 - Taylor & Francis
A Tarhini, D McDermott, A Ambavane, K Gupte-Singh, V Aponte-Ribero, C Ritchings…
Immunotherapy, 2019•Taylor & FrancisAim: 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 …
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 …
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 54,273versusfirst-lineanti-PD-1and 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.
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