NET MONETARY BENEFIT OF IMMUNE CHECKPOINT INHIBITORS IN ADVANCED UROTHELIAL CARCINOMA
Author(s)
Jaseela T. N.k, Masters1, Christy Thomas, phd2, Krishna Undela, PhD1;
1NIPER Guwahati Assam, Guwahati, India, 2NIPER Guwahati Assam, Department of pharmacy practice, Changsari, India
1NIPER Guwahati Assam, Guwahati, India, 2NIPER Guwahati Assam, Department of pharmacy practice, Changsari, India
OBJECTIVES: To determine the pooled incremental net benefit of immune checkpoint inhibitors compared to best supportive care and chemotherapy for advanced urothelial carcinoma
METHODS: A comprehensive literature search was performed in PubMed, Scopus, and Embase. For each included study, incremental net benefit (INB) and its variance were calculated and the standard error (SE) of INB was derived from the variance. Pooled estimates of INB were calculated using a random-effects meta-analysis model implemented in R programming (“meta”package). Heterogeneity across studies was assessed using the I² statistic, and subgroup or sensitivity analyses were conducted where appropriate.
RESULTS: Of the 200 records initially identified,11 studies were included in our review. The pooled incremental net benefit (INB) of ICIs compared to standard treatment was -$4,994 (95% confidence interval : -$21459to $11470.Among the 11 included studies, six (54.5%) demonstrated cost-effectiveness for immune checkpoint inhibitors (ICIs), while five did not. In the subgroup analysis of PD-L1-positive patients,two-thirds (66.7%) showed ICIs to be cost-effective.
CONCLUSIONS: The pooled analysis suggests immune checkpoint inhibitors (ICIs) demonstrate variable cost-effectiveness in advanced urothelial carcinoma, with only half of included studies favoring ICIs over standard therapies. These findings highlight the need for context-specific pricing strategies and further research on biomarker-driven patient selection to optimize value.
METHODS: A comprehensive literature search was performed in PubMed, Scopus, and Embase. For each included study, incremental net benefit (INB) and its variance were calculated and the standard error (SE) of INB was derived from the variance. Pooled estimates of INB were calculated using a random-effects meta-analysis model implemented in R programming (“meta”package). Heterogeneity across studies was assessed using the I² statistic, and subgroup or sensitivity analyses were conducted where appropriate.
RESULTS: Of the 200 records initially identified,11 studies were included in our review. The pooled incremental net benefit (INB) of ICIs compared to standard treatment was -$4,994 (95% confidence interval : -$21459to $11470.Among the 11 included studies, six (54.5%) demonstrated cost-effectiveness for immune checkpoint inhibitors (ICIs), while five did not. In the subgroup analysis of PD-L1-positive patients,two-thirds (66.7%) showed ICIs to be cost-effective.
CONCLUSIONS: The pooled analysis suggests immune checkpoint inhibitors (ICIs) demonstrate variable cost-effectiveness in advanced urothelial carcinoma, with only half of included studies favoring ICIs over standard therapies. These findings highlight the need for context-specific pricing strategies and further research on biomarker-driven patient selection to optimize value.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE257
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology