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Cost Effectiveness of Nivolumab in Patients with Advanced, Previously Treated Squamous and Non-squamous Non-small-cell Lung Cancer in England

OBJECTIVE: The aim of this study was to investigate the cost effectiveness of nivolumab versus docetaxel in previously treated, advanced non–small-cell lung cancer (NSCLC) in England and assess how conditional reimbursement within the Cancer Drugs Fund (CDF) can be used to ensure timely patient acce...

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Autores principales: Rothwell, Ben, Kiff, Christopher, Ling, Caroline, Brodtkorb, Thor-Henrik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8160043/
https://www.ncbi.nlm.nih.gov/pubmed/33332018
http://dx.doi.org/10.1007/s41669-020-00245-4
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author Rothwell, Ben
Kiff, Christopher
Ling, Caroline
Brodtkorb, Thor-Henrik
author_facet Rothwell, Ben
Kiff, Christopher
Ling, Caroline
Brodtkorb, Thor-Henrik
author_sort Rothwell, Ben
collection PubMed
description OBJECTIVE: The aim of this study was to investigate the cost effectiveness of nivolumab versus docetaxel in previously treated, advanced non–small-cell lung cancer (NSCLC) in England and assess how conditional reimbursement within the Cancer Drugs Fund (CDF) can be used to ensure timely patient access to effective treatments. METHODS: Cost-effectiveness models developed for the National Institute for Health and Care Excellence (NICE) TA483 (squamous) and TA484 (non-squamous) technology appraisals were supplemented with updated overall survival (OS), progression-free survival (PFS), and time-to-treatment discontinuation data collected as part of the CDF data collection agreement. Both models were developed by using a partitioned-survival approach based on PFS and OS predictions from CheckMate 017 and CheckMate 057 to estimate the projected proportion of patients in each health state (progression free, progression, death) throughout the model’s time horizon. The primary outcomes were estimated costs, quality-adjusted life-years (QALYs), and the resulting incremental cost-effectiveness ratio (ICER) expressed as cost/QALY gained. RESULTS: Base-case ICERs for treating patients with nivolumab versus docetaxel were £35,657/QALY and £38,703/QALY for squamous and non-squamous NSCLC patients, respectively, which are substantially lower than those obtained from what were deemed to be the most appropriate analyses for decision making in the original submissions when run with the same patient access scheme discount: £68,576/QALY and £73,189/QALY gained for squamous and non-squamous NSCLC, respectively. CONCLUSIONS: Nivolumab versus docetaxel is cost effective for treating locally advanced/metastatic NSCLC after prior chemotherapy in adults, regardless of tumour histology or programmed death-ligand 1 expression status. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41669-020-00245-4.
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spelling pubmed-81600432021-06-17 Cost Effectiveness of Nivolumab in Patients with Advanced, Previously Treated Squamous and Non-squamous Non-small-cell Lung Cancer in England Rothwell, Ben Kiff, Christopher Ling, Caroline Brodtkorb, Thor-Henrik Pharmacoecon Open Original Research Article OBJECTIVE: The aim of this study was to investigate the cost effectiveness of nivolumab versus docetaxel in previously treated, advanced non–small-cell lung cancer (NSCLC) in England and assess how conditional reimbursement within the Cancer Drugs Fund (CDF) can be used to ensure timely patient access to effective treatments. METHODS: Cost-effectiveness models developed for the National Institute for Health and Care Excellence (NICE) TA483 (squamous) and TA484 (non-squamous) technology appraisals were supplemented with updated overall survival (OS), progression-free survival (PFS), and time-to-treatment discontinuation data collected as part of the CDF data collection agreement. Both models were developed by using a partitioned-survival approach based on PFS and OS predictions from CheckMate 017 and CheckMate 057 to estimate the projected proportion of patients in each health state (progression free, progression, death) throughout the model’s time horizon. The primary outcomes were estimated costs, quality-adjusted life-years (QALYs), and the resulting incremental cost-effectiveness ratio (ICER) expressed as cost/QALY gained. RESULTS: Base-case ICERs for treating patients with nivolumab versus docetaxel were £35,657/QALY and £38,703/QALY for squamous and non-squamous NSCLC patients, respectively, which are substantially lower than those obtained from what were deemed to be the most appropriate analyses for decision making in the original submissions when run with the same patient access scheme discount: £68,576/QALY and £73,189/QALY gained for squamous and non-squamous NSCLC, respectively. CONCLUSIONS: Nivolumab versus docetaxel is cost effective for treating locally advanced/metastatic NSCLC after prior chemotherapy in adults, regardless of tumour histology or programmed death-ligand 1 expression status. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41669-020-00245-4. Springer International Publishing 2020-12-17 /pmc/articles/PMC8160043/ /pubmed/33332018 http://dx.doi.org/10.1007/s41669-020-00245-4 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research Article
Rothwell, Ben
Kiff, Christopher
Ling, Caroline
Brodtkorb, Thor-Henrik
Cost Effectiveness of Nivolumab in Patients with Advanced, Previously Treated Squamous and Non-squamous Non-small-cell Lung Cancer in England
title Cost Effectiveness of Nivolumab in Patients with Advanced, Previously Treated Squamous and Non-squamous Non-small-cell Lung Cancer in England
title_full Cost Effectiveness of Nivolumab in Patients with Advanced, Previously Treated Squamous and Non-squamous Non-small-cell Lung Cancer in England
title_fullStr Cost Effectiveness of Nivolumab in Patients with Advanced, Previously Treated Squamous and Non-squamous Non-small-cell Lung Cancer in England
title_full_unstemmed Cost Effectiveness of Nivolumab in Patients with Advanced, Previously Treated Squamous and Non-squamous Non-small-cell Lung Cancer in England
title_short Cost Effectiveness of Nivolumab in Patients with Advanced, Previously Treated Squamous and Non-squamous Non-small-cell Lung Cancer in England
title_sort cost effectiveness of nivolumab in patients with advanced, previously treated squamous and non-squamous non-small-cell lung cancer in england
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8160043/
https://www.ncbi.nlm.nih.gov/pubmed/33332018
http://dx.doi.org/10.1007/s41669-020-00245-4
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