COST-EFFECTIVENESS OF NEOADJUVANT IMMUNOTHERAPY TO TRADITIONAL SURGERY AS INITIAL TREATMENT FOR LOCOREGIONALLY ADVANCED CUTANEOUS SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK
Author(s)
Christian L. Bailey-Burke, AB1, David M. Brizel, MD2, Peter A. Ubel, MD3, Shelby D. Reed, RPh, PhD4, Meenal K. Kheterpal, MD, MMCi5;
1Duke University School of Medicine, Durham, NC, USA, 2Duke University Medical Center, Department of Head and Neck Surgery & Communication Sciences, Durham, NC, USA, 3Duke Fuqua School of Business, Durham, NC, USA, 4Duke Clinical Research Institute, Durham, NC, USA, 5Duke University School of Medicine, Department of Dermatology, Durham, NC, USA
1Duke University School of Medicine, Durham, NC, USA, 2Duke University Medical Center, Department of Head and Neck Surgery & Communication Sciences, Durham, NC, USA, 3Duke Fuqua School of Business, Durham, NC, USA, 4Duke Clinical Research Institute, Durham, NC, USA, 5Duke University School of Medicine, Department of Dermatology, Durham, NC, USA
OBJECTIVES: Cutaneous squamous cell carcinoma occurs with increasing incidence in the aging United States population, and depending on the tumor stage, can require multimodal treatment. Neoadjuvant cemiplimab has shown promise in improving the pathological response and event-free survival, but its cost-effectiveness compared to starting with traditional surgery has not been explored.
METHODS: This health economics evaluation aims to determine if added neoadjuvant cemiplimab is a cost-effective intervention in the management of head and neck locoregionally advanced cutaneous squamous cell carcinoma using a decision tree combined with a state-transition Markov model over a 10-year horizon.
RESULTS: In the base-case analysis, the expected long-term cost per patient was $12,813 lower with the addition of neoadjuvant immunotherapy compared to traditional surgery alone and yielded 0.02 more quality-adjusted life years. However, sensitivity analysis revealed that incremental costs and quality-adjusted life years were sensitive to changes in the time horizon and utility values assigned to health states.
CONCLUSIONS: Neoadjuvant immunotherapy followed by surgery is likely cost-saving and may marginally increase quality-adjusted life years compared to traditional surgery as initial treatment. Future research is needed to clarify long-term costs, outcomes, and corresponding health state utilities.
METHODS: This health economics evaluation aims to determine if added neoadjuvant cemiplimab is a cost-effective intervention in the management of head and neck locoregionally advanced cutaneous squamous cell carcinoma using a decision tree combined with a state-transition Markov model over a 10-year horizon.
RESULTS: In the base-case analysis, the expected long-term cost per patient was $12,813 lower with the addition of neoadjuvant immunotherapy compared to traditional surgery alone and yielded 0.02 more quality-adjusted life years. However, sensitivity analysis revealed that incremental costs and quality-adjusted life years were sensitive to changes in the time horizon and utility values assigned to health states.
CONCLUSIONS: Neoadjuvant immunotherapy followed by surgery is likely cost-saving and may marginally increase quality-adjusted life years compared to traditional surgery as initial treatment. Future research is needed to clarify long-term costs, outcomes, and corresponding health state utilities.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE77
Topic
Economic Evaluation
Disease
SDC: Oncology, SDC: Sensory System Disorders (Ear, Eye, Dental, Skin), STA: Surgery