Cost-Effectiveness of First-Line Pembrolizumab Monotherapy Versus Chemotherapy in High Programmed Death-Ligand 1 Advanced Non–Small Cell Lung Cancer in the Irish Healthcare Setting

• DOI: 10.1016/j.jval.2022.10.012
• Publication Date: 2022-11-08T16:26:01Z
• Authors: Ryan Wong Chu; Antonio Vegas García; Conor Hickey; Derek Gerard Power; Claire Gorry
• Keywords: Incremental cost-effectiveness ratio

This study aimed to assess the cost-effectiveness of pembrolizumab monotherapy in first-line treatment advanced non-small cell lung cancer (NSCLC) adults whose tumors expressed programmed death-ligand 1 (PD-L1) with a tumor proportion score (TPS) ≥ 50% Irish healthcare setting.Effectiveness inputs were derived from 5-year analysis KEYNOTE-024 phase III clinical trial. The intervention was monotherapy; comparator weighted average 5 chemotherapy regimens population included those previously untreated PD-L1 TPS NSCLC. A de novo partitioned survival model developed. Survival modeling done using Bayesian averaging on fitted parametric functions. Costs drug acquisition, initiation, administration and monitoring, adverse events, subsequent treatments, terminal care. health state utilities sourced literature sources. had 20-year time horizon. perspective taken Health Service Executive. 4% discount rate applied. Outcomes as an incremental ratio (ICER), measured terms costs per quality-adjusted life-year (QALY). Probabilistic sensitivity 1-way analyses conducted.The estimated base case ICER €54 237 QALY. probabilistic 568 QALY 11% probability at threshold €45 000 QALY.At current list price, is not considered cost-effective for NSCLC setting.