Health Impact Projection of Anti-PD-1/PD-L1 Therapies in 8 Cancer Indications in Panama

OBJECTIVES: A model was developed to project key health outcomes of the anti-PD-1/PD-L1 class in Panama for patients initiating treatment from 2021-2025 in 8 cancer indications: adjuvant melanoma, metastatic melanoma, first-line non-small cell lung cancer (1L NSCLC), neoadjuvant triple negative breast cancer, colorectal cancer, cervical cancer, renal cell carcinoma (RCC), and head and neck cancer.

METHODS: The Health Impact Projection (HIP) model estimates key health outcomes for patients initiating treatment with anti-PD-1/PD-L1s from 2021 to 2025 in two scenarios: one where patients are treated with standard of care (SOC) only, versus where patients are treated with either anti-PD-1/PD-L1s or SOCs. The scenarios compare patient life years (LY) in overall and progression-free survival (PFS), quality-adjusted life years (QALYs), and adverse events (AE). The model included all patient outcomes for 5 years after treatment initiation.

A partitioned survival model was used to estimate key survival outcomes. Survival data were based on relevant clinical trials.

Cancer incidence was provided by local experts. Class-share inputs were applied to reflect the proportion of patients receiving each treatment in both scenarios. Local experts developed and verified these inputs.

RESULTS: Over the selected time horizon, the model calculated 882 patients would be diagnosed and treated with anti-PD-1/PD-L1 treatments across indications. Gains of 967 LYs (from 11,445 to 12,412, +8%) 934 PFS years (from 4,849 to 5,784, +19%), 788 QALYs (from 8,583 to 9,371, +9%), and -357 AEs experienced (from 4,056 to 3,699, -9%) were estimated when anti-PD-1/PD-L1 treatments are available versus only SOC. Metastatic melanoma saw the largest health outcome impact, then RCC and 1L NSCLC. Real world data could validate these results but was not available at the time of publication.

CONCLUSIONS: Anti-PD-1/PD‐L1s allow a gain in life expectancy and improvement in quality of life, demonstrating their status as therapeutic innovation now, and in the future.