Inpatient Adverse Event Management Costs Associated with Immune Checkpoint Inhibitors for Advanced or Metastatic Cancers in the UK
Author(s)
Jyotika Gandhi, MSc1, Sandip Ranjan, MTech1, Anindya Mukherjee, PGDM1, Susmit Sambhare, PhD1, Rizwan Ameen, MPharm1, Ravi Potluri, MBA2;
1Putnam Associates, Gurgaon, India, 2Putnam Associates, New York, NY, USA
1Putnam Associates, Gurgaon, India, 2Putnam Associates, New York, NY, USA
OBJECTIVES: Over the last decade, ICIs have become integral to treatment of many solid tumors. While ICIs offer significant improvements in survival, they are also associated with AEs that then require additional healthcare resources with attendant costs to manage. This study aimed to estimate AE management costs for each ICI-based regimen approved for patients with advanced or metastatic cancers in the UK.
METHODS: The AE management costs for each ICI regimen were estimated by multiplying the frequency of each grade 3-4 AE by its corresponding management cost. These costs were then summed across all relevant AEs. The frequencies of grade 3-4 AEs were extracted from registrational clinical trial publications for MHRA-approved ICI regimens in their respective indications. For this analysis, it is assumed that all grade 3-4 AEs necessitate inpatient treatment. The unit costs for inpatient stays associated with each AE were obtained from the NHS Reference Cost 2023/24 dataset.
RESULTS: Across cancers, the AE management cost per patient ranged from £27-£575 in melanoma, £62-£1,754 in urothelial cancer, £97-£908 in renal cell carcinoma, £54-£2,560 in head and neck squamous cell carcinoma, £32-£2,131 in lung cancer, £244-£403 in hepatocellular carcinoma, £86-£2,032 in esophageal carcinoma, £1,087-£1,515 in gastroesophageal junction carcinoma, £327-£1,262 in cervical cancer, £527-£1,343 in triple negative breast cancer, £1,770-£2,068 for biliary tract carcinoma and £594-£1,277 for endometrial cancer. For monotherapies, the costs ranged from £27 for nivolumab to £1,687 for atezolizumab. For combination therapies, the costs were in the range of £308 for atezolizumab + bevacizumab to £2,560 for pembrolizumab + cetuximab. For ICI+ICI combinations, costs ranged from £125 for nivolumab + ipilimumab to £1,850 for durvalumab + tremelimumab + platinum-etoposide.
CONCLUSIONS: AE management costs associated with ICIs vary by regimen and cancer type, emphasizing the need to consider these costs when making choices of ICI treatments.
METHODS: The AE management costs for each ICI regimen were estimated by multiplying the frequency of each grade 3-4 AE by its corresponding management cost. These costs were then summed across all relevant AEs. The frequencies of grade 3-4 AEs were extracted from registrational clinical trial publications for MHRA-approved ICI regimens in their respective indications. For this analysis, it is assumed that all grade 3-4 AEs necessitate inpatient treatment. The unit costs for inpatient stays associated with each AE were obtained from the NHS Reference Cost 2023/24 dataset.
RESULTS: Across cancers, the AE management cost per patient ranged from £27-£575 in melanoma, £62-£1,754 in urothelial cancer, £97-£908 in renal cell carcinoma, £54-£2,560 in head and neck squamous cell carcinoma, £32-£2,131 in lung cancer, £244-£403 in hepatocellular carcinoma, £86-£2,032 in esophageal carcinoma, £1,087-£1,515 in gastroesophageal junction carcinoma, £327-£1,262 in cervical cancer, £527-£1,343 in triple negative breast cancer, £1,770-£2,068 for biliary tract carcinoma and £594-£1,277 for endometrial cancer. For monotherapies, the costs ranged from £27 for nivolumab to £1,687 for atezolizumab. For combination therapies, the costs were in the range of £308 for atezolizumab + bevacizumab to £2,560 for pembrolizumab + cetuximab. For ICI+ICI combinations, costs ranged from £125 for nivolumab + ipilimumab to £1,850 for durvalumab + tremelimumab + platinum-etoposide.
CONCLUSIONS: AE management costs associated with ICIs vary by regimen and cancer type, emphasizing the need to consider these costs when making choices of ICI treatments.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE507
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology