The Health Impact of Pembrolizumab in Combination With Chemotherapy for the First-Line Treatment of Patients With Squamous 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, PhD5, Simten Malhan, Prof6, Irfan Cicin, Prof7.
1Merck Sharp & Dohme Ltd. (Turkey), Istanbul, Turkey, 2MSD Sharp & Dohme GmbH, München, Germany, 3MSD, Puteaux, 92800, France, 4Merck & Co. Inc, West Point, PA, USA, 5Merck & Co., Inc, West Point, PA, USA, 6Department of Healthcare Management, Baskent University, Ankara, Turkey, 7Department of Medical Oncology, Istinye University, Istanbul, Turkey.
1Merck Sharp & Dohme Ltd. (Turkey), Istanbul, Turkey, 2MSD Sharp & Dohme GmbH, München, Germany, 3MSD, Puteaux, 92800, France, 4Merck & Co. Inc, West Point, PA, USA, 5Merck & Co., Inc, West Point, PA, USA, 6Department of Healthcare Management, Baskent University, Ankara, Turkey, 7Department of Medical Oncology, Istinye University, 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 diagnosed and 38,505 related deaths in 2022. Of those, 6,502 cases are squamous mNSCLC. This analysis evaluates the health impact of pembrolizumab in this indication.
METHODS: A partitioned survival model was used 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 utilities, and safety were derived from the KEYNOTE-407 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 2.32 for pembrolizumab + chemotherapy vs 1.18 for chemotherapy. Total LYs were estimated to be 2.82 and 1.47 for the pembrolizumab + chemotherapy and chemotherapy arms, respectively. Therefore, the addition of pembrolizumab to chemotherapy was estimated to add 1.14 QALYs and the increment in LYs was 1.35. Results from the DSA, PSA and scenario analyses support the base-case findings. The parameters that had the most impact were the intercept of the Weibull distribution for estimating overall survival for the pembrolizumab + chemotherapy arm, as well as the health utility value for patients ≥ 360 days from death.
CONCLUSIONS: The results indicate that pembrolizumab in combination with chemotherapy for the first-line treatment of patients with 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 used 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 utilities, and safety were derived from the KEYNOTE-407 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 2.32 for pembrolizumab + chemotherapy vs 1.18 for chemotherapy. Total LYs were estimated to be 2.82 and 1.47 for the pembrolizumab + chemotherapy and chemotherapy arms, respectively. Therefore, the addition of pembrolizumab to chemotherapy was estimated to add 1.14 QALYs and the increment in LYs was 1.35. Results from the DSA, PSA and scenario analyses support the base-case findings. The parameters that had the most impact were the intercept of the Weibull distribution for estimating overall survival for the pembrolizumab + chemotherapy arm, as well as the health utility value for patients ≥ 360 days from death.
CONCLUSIONS: The results indicate that pembrolizumab in combination with chemotherapy for the first-line treatment of patients with 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
EPH239
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
Oncology