PROJECTED IMPACT OF INDIVIDUALIZED NEOANTIGEN THERAPY PLUS ANTI-PD-1 ON HEALTH, PRODUCTIVITY AND HEALTH SYSTEM CAPACITY OUTCOMES IN RESECTED STAGE IIIB-IV MELANOMA IN UNITED STATES
Author(s)
Shujing (Shirley) Zhang, PhD1, Elizabeth Wehler, MS2, Shrishti Jain, MS3, Parul Singla, MS3, Alok Kesarwani, MS3.
1Merck & Co., Inc., Rahway, NJ, USA, 2Merck & Co., Inc., West Point, PA, USA, 3Peritia, Morrisville, NC, USA.
1Merck & Co., Inc., Rahway, NJ, USA, 2Merck & Co., Inc., West Point, PA, USA, 3Peritia, Morrisville, NC, USA.
OBJECTIVES: Despite effective adjuvant anti-PD-1 therapies, patients with resected stage IIIB-IV melanoma remain at high risk of recurrence or death after surgery. Individualized neo-antigen therapies (INTs as a drug class) are being investigated across multiple therapeutic areas, with one (intismeran autogene) having shown improved recurrence-free and distant metastasis-free survival in resected stage IIIB-IV melanoma in the phase 2b KEYNOTE-942 trial. This analysis estimates the potential health, productivity, and health system capacity impact of introducing an INT plus anti-PD-1 for these patients in the United States.
METHODS: A four-state Markov model was developed in MS Excel to enable weekly entry of patients and compare health and productivity outcomes over 10 years across two scenarios: (a) an INT plus anti-PD-1 and existing treatments may be used as adjuvant treatment (future scenario), and (b) only existing adjuvant treatments are available (current scenario). Inputs included clinical trial data, national epidemiology statistics, market share assumptions and productivity inputs. Sensitivity analyses on melanoma incidence rate and uptake rate for INTs were conducted.
RESULTS: Over 10 years, 24,453 (55%) of 44,117 eligible US patients with resected stage IIIB-IV melanoma would start an INT plus anti-PD-1 adjuvant therapy. This would extend recurrence-free life years by 12,895 (10%) and quality-adjusted life years by 5,377 (4%). It avoids 5,229 (23%) recurrences and 1,914 (19%) deaths, sparing 5,620 (22%) patients from metastatic treatment. Consequently, intravenous metastatic infusions decrease by 51,712 (21%), while productive years rise by 4,494 (19%) for patients and 989 (19%) for caregivers. Findings were consistent in the sensitivity analyses.
CONCLUSIONS: This analysis demonstrates the potential for an adjuvant INT plus anti-PD-1 to deliver substantial health outcomes and productivity benefits in resected stage IIIB-IV melanoma. By extending recurrence-free and overall life years, an INT plus anti-PD-1 may potentially alleviate health system capacity burdens and improve productivity for both patients and caregivers.
METHODS: A four-state Markov model was developed in MS Excel to enable weekly entry of patients and compare health and productivity outcomes over 10 years across two scenarios: (a) an INT plus anti-PD-1 and existing treatments may be used as adjuvant treatment (future scenario), and (b) only existing adjuvant treatments are available (current scenario). Inputs included clinical trial data, national epidemiology statistics, market share assumptions and productivity inputs. Sensitivity analyses on melanoma incidence rate and uptake rate for INTs were conducted.
RESULTS: Over 10 years, 24,453 (55%) of 44,117 eligible US patients with resected stage IIIB-IV melanoma would start an INT plus anti-PD-1 adjuvant therapy. This would extend recurrence-free life years by 12,895 (10%) and quality-adjusted life years by 5,377 (4%). It avoids 5,229 (23%) recurrences and 1,914 (19%) deaths, sparing 5,620 (22%) patients from metastatic treatment. Consequently, intravenous metastatic infusions decrease by 51,712 (21%), while productive years rise by 4,494 (19%) for patients and 989 (19%) for caregivers. Findings were consistent in the sensitivity analyses.
CONCLUSIONS: This analysis demonstrates the potential for an adjuvant INT plus anti-PD-1 to deliver substantial health outcomes and productivity benefits in resected stage IIIB-IV melanoma. By extending recurrence-free and overall life years, an INT plus anti-PD-1 may potentially alleviate health system capacity burdens and improve productivity for both patients and caregivers.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE545
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis, Novel & Social Elements of Value, Work & Home Productivity - Indirect Costs
Disease
Oncology