The Health Impact of Pembrolizumab in Combination With Chemotherapy for the First-Line Treatment of Patients With Nonsquamous Metastatic Non-Small Cell Lung Cancer (mNSCLC) in Türkiye
Author(s)
Burcu Akyol Ersoy, BSc, MBA1, Yasemin Ceylan, BSc1, Ugur Akpamuk, BSc1, Gozde Ozcan, MSc1, Yasemin Esen, MD1, Mert Batum, MD1, Berfin Torun, MD1, Bernadette Poellinger, PhD2, Carole Mamane, BSc, MSc3, Ralph Insinga, PhD4, Danmeng Huang, PhD4, Simten Malhan, Prof5, Irfan Cicin, Prof6.
1Merck Sharp & Dohme Ltd. (Turkey), Istanbul, Turkey, 2MSD Sharp & Dohme GmbH, München, Germany, 3MSD France, Puteaux, 92800, France, 4Merck & Co. Inc, West Point, PA, USA, 5Department of Healthcare Management, Baskent University, Ankara, Turkey, 6Department of Medical Oncology, Istinye University, Faculty of Medicine, Istanbul, Turkey.
1Merck Sharp & Dohme Ltd. (Turkey), Istanbul, Turkey, 2MSD Sharp & Dohme GmbH, München, Germany, 3MSD France, Puteaux, 92800, France, 4Merck & Co. Inc, West Point, PA, USA, 5Department of Healthcare Management, Baskent University, Ankara, Turkey, 6Department of Medical Oncology, Istinye University, Faculty of Medicine, Istanbul, Turkey.
OBJECTIVES: Lung cancer (LC) is the leading cause of cancer-related mortality worldwide, accounting for nearly 20% of all cancer deaths. In Türkiye, LC was the most common and deadliest cancer, with 41,032 new cases and 38,505 related deaths in 2022. Of those, 10,883 cases are non-squamous mNSCLC. This analysis aims to estimate the health impact of pembrolizumab in this indication.
METHODS: A partitioned survival model was developed and adapted to a Turkish payer perspective to compare potential health impact in terms of life years (LYs) and quality-adjusted life years (QALYs) of the combination of pembrolizumab plus chemotherapy to chemotherapy alone. Data on clinical effectiveness, treatment utilization, health utility, and safety were derived from the KEYNOTE-189 trial and projected over a 20-year horizon. A 3% annual discount rate was applied to health outcomes. Scenario, deterministic (DSA) and probabilistic sensitivity analyses (PSA) were conducted to test the robustness of the model results.
RESULTS: According to the model applied, total QALYs were estimated to be 2.69 for pembrolizumab + chemotherapy vs 1.20 for chemotherapy. Total LYs were estimated to be 3.31 and 1.52 for the pembrolizumab + chemotherapy and chemotherapy arms, respectively. Therefore, the addition of pembrolizumab to chemotherapy was estimated to add 1.49 QALYs and the increment in LYs was 1.79. Results from the DSA, PSA and scenario analyses support the base-case findings. The parameters that had the most impact were the pooled health utility value for patients with ≥ 360 days from death, and the parametric values for fitting time on treatment for pembrolizumab + chemotherapy.
CONCLUSIONS: The results indicate that pembrolizumab in combination with chemotherapy for the first-line treatment of patients with non-squamous mNSCLC in Türkiye yields substantive incremental QALYs and LYs and should be considered for public reimbursement in Türkiye.
METHODS: A partitioned survival model was developed and adapted to a Turkish payer perspective to compare potential health impact in terms of life years (LYs) and quality-adjusted life years (QALYs) of the combination of pembrolizumab plus chemotherapy to chemotherapy alone. Data on clinical effectiveness, treatment utilization, health utility, and safety were derived from the KEYNOTE-189 trial and projected over a 20-year horizon. A 3% annual discount rate was applied to health outcomes. Scenario, deterministic (DSA) and probabilistic sensitivity analyses (PSA) were conducted to test the robustness of the model results.
RESULTS: According to the model applied, total QALYs were estimated to be 2.69 for pembrolizumab + chemotherapy vs 1.20 for chemotherapy. Total LYs were estimated to be 3.31 and 1.52 for the pembrolizumab + chemotherapy and chemotherapy arms, respectively. Therefore, the addition of pembrolizumab to chemotherapy was estimated to add 1.49 QALYs and the increment in LYs was 1.79. Results from the DSA, PSA and scenario analyses support the base-case findings. The parameters that had the most impact were the pooled health utility value for patients with ≥ 360 days from death, and the parametric values for fitting time on treatment for pembrolizumab + chemotherapy.
CONCLUSIONS: The results indicate that pembrolizumab in combination with chemotherapy for the first-line treatment of patients with non-squamous mNSCLC in Türkiye yields substantive incremental QALYs and LYs and should be considered for public reimbursement in Türkiye.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH238
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
Oncology