Nivolumab plus ipilimumab cost effective for advanced melanoma

Nivolumab plus ipilimumab cost effective for advanced melanoma PharmacoEconomics & Outcomes News 804, p22 - 2 Jun 2018 Nivolumab plus ipilimumab cost effective for advanced melanoma Whether or not overall survival (OS) data are used in cost-effectiveness analysis, the combination of nivolumab and ipilimumab appears to be cost effective in patients with advanced melanoma in England, according to findings of a Bristol-Myers Squibb Pharmaceuticals-funded study published in PharmacoEconomics - Open. A partitioned survival model and a Markov model were used to evaluate the cost effectiveness of nivolumab plus ipilimumab, compared with ipilimumab alone in adults with unresectable or metastatic melanoma, over a lifetime time horizon. The models were populated with 18-month progression-free survival (PFS) data or 36-month with OS data from the head-to-head, phase III CheckMate 067 trial. PFS was estimated from pre-progression survival and time to progression. Patient-level data was used to estimate post-progression survival (PPS). Based on list prices of the drugs, the models without and with OS data found similar absolute costs for nivolumab plus ipilimumab and for ipilimumab alone; total incremental costs were £11 438 and £12 084, respectively. Incremental QALY gains with combination therapy compared with ipilimumab alone were 2.54 and 2.86, respectively. In both models, nivolumab plus ipilimumab was more cost effective than ipilimumab alone, with estimated incremental cost-effectiveness ratios (ICERs) of £4225 and £4502 per QALY gained, respectively. Cost-effectiveness acceptability curves showed that nivolumab plus ipilimumab was the regimen most likely to be cost effective at willingness-to-pay thresholds of £30 000 and £50 000, per QALY gained. "Although it may lead to conservative estimates of OS, our analysis shows that for comparators with similar mechanisms of action, assuming equal PPS or using data from earlier data-cuts can go some way to overcoming this limitation, providing comparable ICERs in the absence of OS data," said the authors. * 2015 British pounds Lee D, et al. Can We Accurately Predict Cost Effectiveness Without Access to Overall Survival Data? The Case Study of Nivolumab in Combination with Ipilimumab for the Treatment of Patients with Advanced Melanoma in England. PharmacoEconomics-Open : 22 May 2018. Available from: URL: https:// doi.org/10.1007/s41669-018-0080-5 803323501 1173-5503/18/0804-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Jun 2018 No. 804 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png PharmacoEconomics & Outcomes News Springer Journals

Nivolumab plus ipilimumab cost effective for advanced melanoma

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Publisher
Springer International Publishing
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Pharmacoeconomics and Health Outcomes; Quality of Life Research; Health Economics; Public Health
ISSN
1173-5503
eISSN
1179-2043
D.O.I.
10.1007/s40274-018-4986-z
Publisher site
See Article on Publisher Site

Abstract

PharmacoEconomics & Outcomes News 804, p22 - 2 Jun 2018 Nivolumab plus ipilimumab cost effective for advanced melanoma Whether or not overall survival (OS) data are used in cost-effectiveness analysis, the combination of nivolumab and ipilimumab appears to be cost effective in patients with advanced melanoma in England, according to findings of a Bristol-Myers Squibb Pharmaceuticals-funded study published in PharmacoEconomics - Open. A partitioned survival model and a Markov model were used to evaluate the cost effectiveness of nivolumab plus ipilimumab, compared with ipilimumab alone in adults with unresectable or metastatic melanoma, over a lifetime time horizon. The models were populated with 18-month progression-free survival (PFS) data or 36-month with OS data from the head-to-head, phase III CheckMate 067 trial. PFS was estimated from pre-progression survival and time to progression. Patient-level data was used to estimate post-progression survival (PPS). Based on list prices of the drugs, the models without and with OS data found similar absolute costs for nivolumab plus ipilimumab and for ipilimumab alone; total incremental costs were £11 438 and £12 084, respectively. Incremental QALY gains with combination therapy compared with ipilimumab alone were 2.54 and 2.86, respectively. In both models, nivolumab plus ipilimumab was more cost effective than ipilimumab alone, with estimated incremental cost-effectiveness ratios (ICERs) of £4225 and £4502 per QALY gained, respectively. Cost-effectiveness acceptability curves showed that nivolumab plus ipilimumab was the regimen most likely to be cost effective at willingness-to-pay thresholds of £30 000 and £50 000, per QALY gained. "Although it may lead to conservative estimates of OS, our analysis shows that for comparators with similar mechanisms of action, assuming equal PPS or using data from earlier data-cuts can go some way to overcoming this limitation, providing comparable ICERs in the absence of OS data," said the authors. * 2015 British pounds Lee D, et al. Can We Accurately Predict Cost Effectiveness Without Access to Overall Survival Data? The Case Study of Nivolumab in Combination with Ipilimumab for the Treatment of Patients with Advanced Melanoma in England. PharmacoEconomics-Open : 22 May 2018. Available from: URL: https:// doi.org/10.1007/s41669-018-0080-5 803323501 1173-5503/18/0804-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Jun 2018 No. 804

Journal

PharmacoEconomics & Outcomes NewsSpringer Journals

Published: Jun 2, 2018

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