Inpatient Cost of Managing Adverse Events (AEs) Associated With Immune Checkpoint Inhibitors (ICI) Approved 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, Gurugram, India, 2Putnam, New York, NY, USA.
1Putnam, Gurugram, India, 2Putnam, New York, NY, USA.
OBJECTIVES: Over the last decade, ICIs have become integral to treatment of numerous solid tumors. While offering significant survival benefits, ICIs are associated with AEs that often require additional healthcare resources. 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 calculated by multiplying the incidence 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 ICI regimens in their respective MHRA-approved 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 cancer types, per-patient AE management cost 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: Inpatient AE management costs associated with ICI therapies vary by regimen and cancer type, emphasizing the need to consider these costs in decision-making of ICI treatments.
METHODS: The AE management costs for each ICI regimen were calculated by multiplying the incidence 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 ICI regimens in their respective MHRA-approved 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 cancer types, per-patient AE management cost 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: Inpatient AE management costs associated with ICI therapies vary by regimen and cancer type, emphasizing the need to consider these costs in decision-making of ICI treatments.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE556
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology