BIUXX
Author(s)
Raquel Aguiar-Ibáñez, BS, MSc1, Shalini Kumari, BS, MSc2, Giselle M. Ojeda3, Miguel Cervantes, MD4, Ying Xiao, BS, MSc5.
1Merck Canada, Toronto, ON, Canada, 2Peritia, North Wales, PA, USA, 3Lima, Peru, 4MSD, Lima, Peru, 5MSD, London, United Kingdom.
1Merck Canada, Toronto, ON, Canada, 2Peritia, North Wales, PA, USA, 3Lima, Peru, 4MSD, Lima, Peru, 5MSD, London, United Kingdom.
OBJECTIVES: Cancer imposes a substantial and growing global health and economic burden, prompting interest in more efficient care delivery models. Subcutaneous (SC) formulations of oncology therapies, including pembrolizumab (KEYTRUDA®), may reduce healthcare resource use and improve patient convenience compared with intravenous (IV) administration. Pembrolizumab with berahyaluronidase-alfa for subcutaneous administration has demonstrated comparable pharmacokinetic exposure and showed consistent efficacy and safety results versus IV pembrolizumab, with reduced active healthcare professional (HCP) time observed in a time-and-motion study. The objective of this study was to estimate and compare the costs of pembrolizumab SC versus IV from the perspective of the Peruvian public healthcare payer.
METHODS: A cost-minimization model (CMM) was developed in Excel, assuming equivalent clinical outcomes between formulations. A decision-tree structure evaluated costs over a 1-year time horizon (with 2-year scenarios). Cost components included drug acquisition (assuming price parity per administration), administration fees, active HCP time, consumables, and IV-specific costs (e.g., venous access devices). Deterministic (one-way and scenario analyses) and probabilistic sensitivity analyses (PSA; 1,000 Monte Carlo iterations) assessed robustness of the results.
RESULTS: In the base case, total costs were lower for pembrolizumab SC (S/ 232,919) versus IV (S/ 242,096), yielding savings of S/ 9,177 per patient. As acquisition costs were equal, savings were driven by reduced HCP time and consumables (-S/ 7,093) and lower administration costs (-S/ 2,085). Sensitivity analyses confirmed robustness, with savings ranging from -S/ 7,938 to -S/ 17,071, most sensitive to time horizon and consumable costs. PSA results showed mean savings of approximately S/ 9,170, with narrow variability, indicating consistency.
CONCLUSIONS: Pembrolizumab SC is a cost-saving alternative to IV in Peru, driven by reduced administration burden. Findings were robust across analyses, supporting a favorable economic profile without compromising clinical outcomes.
METHODS: A cost-minimization model (CMM) was developed in Excel, assuming equivalent clinical outcomes between formulations. A decision-tree structure evaluated costs over a 1-year time horizon (with 2-year scenarios). Cost components included drug acquisition (assuming price parity per administration), administration fees, active HCP time, consumables, and IV-specific costs (e.g., venous access devices). Deterministic (one-way and scenario analyses) and probabilistic sensitivity analyses (PSA; 1,000 Monte Carlo iterations) assessed robustness of the results.
RESULTS: In the base case, total costs were lower for pembrolizumab SC (S/ 232,919) versus IV (S/ 242,096), yielding savings of S/ 9,177 per patient. As acquisition costs were equal, savings were driven by reduced HCP time and consumables (-S/ 7,093) and lower administration costs (-S/ 2,085). Sensitivity analyses confirmed robustness, with savings ranging from -S/ 7,938 to -S/ 17,071, most sensitive to time horizon and consumable costs. PSA results showed mean savings of approximately S/ 9,170, with narrow variability, indicating consistency.
CONCLUSIONS: Pembrolizumab SC is a cost-saving alternative to IV in Peru, driven by reduced administration burden. Findings were robust across analyses, supporting a favorable economic profile without compromising clinical outcomes.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE219
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Health Technology Assessment
Disease
Oncology