Cost-Effectiveness of Dostarlimab in the Treatment of Newly Diagnosed Patients with Locally Advanced Rectal Cancer: Early Economic Modelling.
Author(s)
Kehinde A. Adedayo, MSc;
City, University of London, Research Associate in Health Economics, London, United Kingdom
City, University of London, Research Associate in Health Economics, London, United Kingdom
Presentation Documents
OBJECTIVES: This study evaluated the cost-utility of dostarlimab versus standard of care (SoC) for newly diagnosed rectal cancer patients by considering cost, health outcomes, and incremental cost-effectiveness from the UK National Health Service (NHS) and Personal Social Service (PSS) perspective.
METHODS: An early-stage cost-effectiveness Markov model was developed projecting lifetime costs and outcomes associated with dostarlimab and SoC. Inputs were based on published literature. With the limited data available, this study was conducted as an early economic evaluation. The model structure, inputs and assumptions were validated by medical experts. This analysis assumed a lifetime horizon, with costs and outcomes discounted at 3.5% annually. Deterministic, probabilistic sensitivity analysis (PSA), and scenario analysis were conducted to explore the impact of uncertainties on cost-effectiveness and identify key determinants of economic value.
RESULTS: Dostarlimab at the NHS list price, incurred an incremental cost of £38,454, an additional 1.58 life years, and 1.43 quality-adjusted life years (QALY) compared to SoC. The key determinants of dostarlimab health economic value included its efficacy, time in disease-free survival post-dostarlimab treatment, post-dostarlimab disease-free monitoring costs, duration of disease-free survival post-curative surgery and costs for treating recurrent/metastatic disease. PSA revealed a 68% probability of dostarlimab being cost-effective at £30,000 per QALY, 39% at £25,000 per QALY, and 4% at £20,000 per QALY. Dostarlimab significantly reduces the rate of surgical resection (64% with SoC vs. 6% with dostarlimab) and serves as an organ-sparing strategy.
CONCLUSIONS: This economic assessment suggests that dostarlimab may be cost-effective compared to SoC. It identifies specific steps in patient pathways and outcomes that would determine the economic value that require further research. The model relied on a limited set of inputs and assumptions hence to ensure its robustness and clinical plausibility, the model underwent thorough internal validation to ensure robust core assumptions and usefulness despite limited data.
METHODS: An early-stage cost-effectiveness Markov model was developed projecting lifetime costs and outcomes associated with dostarlimab and SoC. Inputs were based on published literature. With the limited data available, this study was conducted as an early economic evaluation. The model structure, inputs and assumptions were validated by medical experts. This analysis assumed a lifetime horizon, with costs and outcomes discounted at 3.5% annually. Deterministic, probabilistic sensitivity analysis (PSA), and scenario analysis were conducted to explore the impact of uncertainties on cost-effectiveness and identify key determinants of economic value.
RESULTS: Dostarlimab at the NHS list price, incurred an incremental cost of £38,454, an additional 1.58 life years, and 1.43 quality-adjusted life years (QALY) compared to SoC. The key determinants of dostarlimab health economic value included its efficacy, time in disease-free survival post-dostarlimab treatment, post-dostarlimab disease-free monitoring costs, duration of disease-free survival post-curative surgery and costs for treating recurrent/metastatic disease. PSA revealed a 68% probability of dostarlimab being cost-effective at £30,000 per QALY, 39% at £25,000 per QALY, and 4% at £20,000 per QALY. Dostarlimab significantly reduces the rate of surgical resection (64% with SoC vs. 6% with dostarlimab) and serves as an organ-sparing strategy.
CONCLUSIONS: This economic assessment suggests that dostarlimab may be cost-effective compared to SoC. It identifies specific steps in patient pathways and outcomes that would determine the economic value that require further research. The model relied on a limited set of inputs and assumptions hence to ensure its robustness and clinical plausibility, the model underwent thorough internal validation to ensure robust core assumptions and usefulness despite limited data.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE267
Topic
Economic Evaluation
Disease
SDC: Oncology, STA: Alternative Medicine