التفاصيل البيبلوغرافية
| العنوان: |
Cost-effectiveness of pembrolizumab with axitinib as first-line treatment for advanced renal cell carcinoma. |
| المؤلفون: |
Bensimon, Arielle G., Zhong, Yichen, Swami, Umang, Briggs, Allison, Young, Joshua, Feng, Yuan, Song, Yan, Signorovitch, James, Adejoro, Oluwakayode, Chakravarty, Abhiroop, Chen, Mei, Perini, Rodolfo F., Geynisman, Daniel M. |
| المصدر: |
Current Medical Research & Opinion; Sep2020, Vol. 36 Issue 9, p1507-1517, 11p |
| مصطلحات موضوعية: |
IPILIMUMAB, RENAL cell carcinoma, ADVERSE health care events, COST effectiveness, PROGRESSION-free survival, LIFE expectancy |
| مستخلص: |
Pembrolizumab/axitinib significantly prolonged overall survival (OS) and progression-free survival (PFS), and increased objective response rate versus sunitinib in the phase III trial KEYNOTE-426 among previously untreated patients with advanced renal cell carcinoma (RCC). This study assessed the cost-effectiveness of pembrolizumab/axitinib versus other first-line treatments of advanced RCC from a US public healthcare payer perspective. A partitioned survival model with three states (progression-free, progressed, death) evaluated lifetime costs and quality-adjusted life-years (QALYs) for pembrolizumab/axitinib and other first-line regimens: sunitinib, pazopanib and avelumab/axitinib in the overall population; and sunitinib, cabozantinib and nivolumab/ipilimumab in the subgroup with intermediate/poor prognostic risk. Costs of treatments, adverse events and medical resources were estimated. OS, PFS and treatment duration were extrapolated using parametric models fitted to KEYNOTE-426 data and hazard ratios from network meta-analyses. Utilities were derived through mixed-effects regressions of KEYNOTE-426 EuroQol-5 Dimensions-3 Levels data. In the overall population, pembrolizumab/axitinib was associated with incremental cost-effectiveness ratios (ICERs) of $95,725/QALY versus sunitinib and $128,210/QALY versus pazopanib, and was dominant (lower cost, higher effectiveness) versus avelumab/axitinib, with incremental QALY gains of 2.73, 2.40 and 1.80 versus these therapies, respectively. In the intermediate/poor-risk subgroup, base-case ICERs for pembrolizumab/axitinib were $101,030/QALY versus sunitinib, $6989/QALY versus cabozantinib, and $130,934/QALY versus nivolumab/ipilimumab, with incremental QALY gains of 2.62, 1.78 and 1.06 versus these therapies. In this economic evaluation, pembrolizumab/axitinib was associated with higher life expectancy and QALYs and, based on typical willingness-to-pay thresholds of $150,000–$180,000/QALY, was found cost-effective versus other first-line treatments for advanced RCC in the US. [ABSTRACT FROM AUTHOR] |
|
Copyright of Current Medical Research & Opinion is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
