Cost Per Recurrence-Free Survivor (CPRS) and Cost Per Recurrence-Free Life Month (CPRLM) of Adjuvant Nivolumab (NIVO) Versus Pembrolizumab (PEMBRO) Among Patients With Resected Stage IIB/IIC Melanoma

Speaker(s)

Davis JM1, Srinivasan S2, Du X3, Xu C3, Linton J4, Betts K3, Shelley K4
1Atrium Health Levine Cancer, Charlotte, NC, USA, 2Bristol Myers Squibb, Hamilton, NJ, USA, 3Analysis Group, Inc., Los Angeles, CA, USA, 4Bristol Myers Squibb, Lawrenceville, NJ, USA

Presentation Documents

OBJECTIVES: Both NIVO and PEMBRO have been approved by the US Food and Drug Administration (FDA) as adjuvant treatments for patients with resected stage IIB/IIC melanoma in the US. It is important to understand the cost per outcome of the two treatments to inform payers and decision-makers. This study compared the CPRS and CPRLM of NIVO vs. PEMBRO from a US payer perspective.

METHODS: RFS rates were derived from an indirect comparison of adjuvant NIVO (CheckMate 76K, median follow-up: 23.5 months) versus PEMBRO (KEYNOTE-716, median follow-up: 27.4 months). Treatment costs (2023 USD) included costs of drug acquisition, drug administration, and management of grade 3/4 adverse events. The monthly incremental CPRS for adjuvant NIVO or PEMBRO relative to PBO was calculated as the difference in monthly costs divided by the difference in RFS rates at 12 and 24 months. Similarly, the incremental CPRLM was estimated as the difference in total cost divided by the difference in restricted mean survival time over 12 months and 24 months. A sensitivity analysis was conducted excluding new primary melanomas (including melanoma in situ) as RFS events from both trials.

RESULTS: The monthly incremental CPRS relative to PBO for adjuvant NIVO were consistently lower than that for adjuvant PEMBRO (12 months: $169,181 vs. $173,872; 24 months: $40,594 vs. $76,035). Similarly, NIVO had consistently lower incremental CPRLM (relative to PBO) compared with PEMBRO with a difference in incremental CPRLM of -$346,708 ($244,964 vs. $591,671) over 12 months, and -$48,112 ($73,018 vs. $121,130) over 24 months. The sensitivity analysis showed similar trends.

CONCLUSIONS: Adjuvant NIVO had consistently lower incremental CPRS and CPRLM (relative to PBO) compared with adjuvant PEMBRO. This suggests the potential for long-term cost savings associated with the use of adjuvant NIVO vs. PEMBRO in resected stage IIB/IIC melanoma in the US.

Code

EE47

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Drugs, Oncology