The Health Impact of Pembrolizumab Plus Chemotherapy in the First-Line Treatment for Metastatic Triple-Negative Breast Cancer (TNBC) in Türkiye
Author(s)
Burcu Akyol Ersoy, BSc, MBA1, Yasemin Ceylan, BSc1, Ugur Akpamuk, BSc1, Gozde Ozcan, MSc1, Yasemin Esen, MD1, Mert Batum, MD1, Mert Oklay, DVM1, Bernadette Poellinger, PhD2, Carole Mamane, BSc, MSc3, Amin Haiderali, MBA, MPH4, Aurelien Jamotte, MSc5, Simten Malhan, Prof6, Irfan Cicin, Prof7.
1Merck Sharp & Dohme Ltd. (Turkey), Istanbul, Turkey, 2MSD Sharp & Dohme GmbH, München, Germany, 3MSD France, Puteaux, 92800, France, 4Merck & Co., Inc., Rahway, NJ, USA, 5MSD Innovation & Development GmbH, Zurich, Switzerland, 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 France, Puteaux, 92800, France, 4Merck & Co., Inc., Rahway, NJ, USA, 5MSD Innovation & Development GmbH, Zurich, Switzerland, 6Department of Healthcare Management, Baskent University, Ankara, Turkey, 7Department of Medical Oncology, Istinye University, Istanbul, Turkey.
OBJECTIVES: Breast cancer (BC) is the most common cancer among women globally, accounting for 1 in every 4 diagnosed female cancers. In Türkiye, BC is the most common and deadliest cancer for women with 25,249 new cases and 7,360 related deaths in 2022. Among those, 1,022 cases were associated with locally recurrent inoperable or metastatic TNBC expressing PD-L1 (CPS≥10). This analysis aims to evaluate the health impact of pembrolizumab in combination with chemotherapy as a first-line treatment for patients with locally recurrent inoperable or metastatic TNBC whose tumors express PD-L1 (CPS≥10).
METHODS: A partitioned survival model was developed and adapted to the Turkish payer perspective to compare potential health impact in terms of life years (LYs) and quality-adjusted life years (QALYs) of pembrolizumab plus chemotherapy to chemotherapy alone. Clinical efficacy, treatment utilization, health utilities, and safety data were derived from the KEYNOTE-355 trial and projected over a lifetime (20-year) time 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: Total QALYs over were estimated to be 2.38 for pembrolizumab + chemotherapy vs 1.70 for chemotherapy (+0.68). Total LYs were estimated to be 2.97 and 2.16 for the pembrolizumab + chemotherapy and chemotherapy arms, respectively (+0.81). Results from the DSA, PSA and scenario analyses generally supported the base-case findings, with the most impactful parameters being related to OS extrapolations.
CONCLUSIONS: The results indicate that pembrolizumab plus chemotherapy for patients with locally recurrent inoperable or metastatic TNBC whose tumors express PD-L1 (CPS≥10) is estimated to improve life expectancy and quality of life over standard of care and thus should be considered for public reimbursement in Türkiye.
METHODS: A partitioned survival model was developed and adapted to the Turkish payer perspective to compare potential health impact in terms of life years (LYs) and quality-adjusted life years (QALYs) of pembrolizumab plus chemotherapy to chemotherapy alone. Clinical efficacy, treatment utilization, health utilities, and safety data were derived from the KEYNOTE-355 trial and projected over a lifetime (20-year) time 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: Total QALYs over were estimated to be 2.38 for pembrolizumab + chemotherapy vs 1.70 for chemotherapy (+0.68). Total LYs were estimated to be 2.97 and 2.16 for the pembrolizumab + chemotherapy and chemotherapy arms, respectively (+0.81). Results from the DSA, PSA and scenario analyses generally supported the base-case findings, with the most impactful parameters being related to OS extrapolations.
CONCLUSIONS: The results indicate that pembrolizumab plus chemotherapy for patients with locally recurrent inoperable or metastatic TNBC whose tumors express PD-L1 (CPS≥10) is estimated to improve life expectancy and quality of life over standard of care and thus 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
EPH240
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
Oncology