THE HEALTH IMPACT OF PEMBROLIZUMAB FOR THE FIRST-LINE TREATMENT FOR PERSISTENT, RECURRENT, OR METASTATIC CERVICAL CANCER (PRMCC) IN TURKIYE
Author(s)
Burcu Akyol Ersoy, BSc, MBA1, Nuri Karadurmus, Prof. Dr.2, Ugur Akpamuk, BSc1, Yasemin Ceylan1, Gozde Ozcan, MSc1, Yasemin Esen, MD1, Mert Batum, MD1, Feride Ceren Erdal, MD1, Bernadette Poellinger, PhD3, Carole Mamane, BSc, MSc4, Elizabeth Beaulieu, MA, PhD5, Adnan Alsumali, PhD6, Maulidia Ekaputri, MD7, Mehmet Ali Nahit Sendur, Prof. Dr.8, Sercan Aksoy, Prof. Dr.9.
1Merck Sharp & Dohme Ltd. (Turkey), Istanbul, Turkey, 2Gulhane Training and Research Hospital, Ankara, Turkey, 3MSD Sharp & Dohme GmbH, München, Germany, 4MSD France, Puteaux, France, 5Merck Sharp & Dohme LLC, Rahway, NJ, USA, 6Merck Sharp & Dohme, Dubai, United Arab Emirates, 7Amaris Consulting, Paris, France, 8Yıldırım Beyazıt University Medical Faculty, Ankara, Turkey, 9Hacettepe University Faculty of Medicine, Ankara, Turkey.
1Merck Sharp & Dohme Ltd. (Turkey), Istanbul, Turkey, 2Gulhane Training and Research Hospital, Ankara, Turkey, 3MSD Sharp & Dohme GmbH, München, Germany, 4MSD France, Puteaux, France, 5Merck Sharp & Dohme LLC, Rahway, NJ, USA, 6Merck Sharp & Dohme, Dubai, United Arab Emirates, 7Amaris Consulting, Paris, France, 8Yıldırım Beyazıt University Medical Faculty, Ankara, Turkey, 9Hacettepe University Faculty of Medicine, Ankara, Turkey.
OBJECTIVES: Cervical cancer (CC) is the fourth most common cancer in women worldwide, with 662,301 new cases and 348,874 deaths in 2022. In Türkiye, although pembrolizumab in combination with platinum-doublet±bevacizumab is approved by Ministry of Health for persistent, recurrent, or metastatic cervical cancer (PRMCC), treatment remains predominantly based on platinum-based chemotherapy±bevacizumab, reflecting current access limitations.
This analysis aims to evaluate the health impact of pembrolizumab in combination with platinum-doublet±bevacizumab versus platinum-doublet±bevacizumab alone for the first-line treatment of PRMCC in patients with PD-L1 status CPS>=1.
METHODS: A semi-Markov state transition model adapted to the Turkish healthcare payer perspective to compare the health impact in terms of life years (LYs) and quality-adjusted life years (QALYs) of pembrolizumab in combination with platinum-doublet±bevacizumab versus platinum-doublet±bevacizumab alone with a lifetime time horizon. Efficacy, safety and utility data were based on the KEYNOTE-826 trial, (May 2021, cut-off date). In the base-case analysis, QALYs were discounted by 3% and LYs by 0% annually. Scenario, deterministic (DSA) and probabilistic sensitivity analyses (PSA) were conducted to test the robustness of the model results.
RESULTS: The model estimated total QALYs per patient of 3.72 for pembrolizumab + platinum-doublet±bevacizumab vs 1.73 for platinum-doublet±bevacizumab. Total LYs per patient were estimated to be 7.47 and 2.91 for pembrolizumab + platinum-doublet±bevacizumab and platinum-doublet±bevacizumab, respectively. The use of pembrolizumab was associated with an incremental gain of 1.99 QALYs and 4.56 LYs per patient. DSA, PSA and scenario analyses results support the robustness of base-case results as the overall model conclusions didn’t change across the sensitivity analyses.
CONCLUSIONS: The results indicate that pembrolizumab in combination with platinum-doublet±bevacizumab for the first-line treatment for PRMCC, PD-L1 CPS≥ 1 population in Türkiye yields a significant incremental gain in both LYs and QALYs. Therefore, pembrolizumab is expected to generate considerable benefits for patient lives, the healthcare system, and public.
This analysis aims to evaluate the health impact of pembrolizumab in combination with platinum-doublet±bevacizumab versus platinum-doublet±bevacizumab alone for the first-line treatment of PRMCC in patients with PD-L1 status CPS>=1.
METHODS: A semi-Markov state transition model adapted to the Turkish healthcare payer perspective to compare the health impact in terms of life years (LYs) and quality-adjusted life years (QALYs) of pembrolizumab in combination with platinum-doublet±bevacizumab versus platinum-doublet±bevacizumab alone with a lifetime time horizon. Efficacy, safety and utility data were based on the KEYNOTE-826 trial, (May 2021, cut-off date). In the base-case analysis, QALYs were discounted by 3% and LYs by 0% annually. Scenario, deterministic (DSA) and probabilistic sensitivity analyses (PSA) were conducted to test the robustness of the model results.
RESULTS: The model estimated total QALYs per patient of 3.72 for pembrolizumab + platinum-doublet±bevacizumab vs 1.73 for platinum-doublet±bevacizumab. Total LYs per patient were estimated to be 7.47 and 2.91 for pembrolizumab + platinum-doublet±bevacizumab and platinum-doublet±bevacizumab, respectively. The use of pembrolizumab was associated with an incremental gain of 1.99 QALYs and 4.56 LYs per patient. DSA, PSA and scenario analyses results support the robustness of base-case results as the overall model conclusions didn’t change across the sensitivity analyses.
CONCLUSIONS: The results indicate that pembrolizumab in combination with platinum-doublet±bevacizumab for the first-line treatment for PRMCC, PD-L1 CPS≥ 1 population in Türkiye yields a significant incremental gain in both LYs and QALYs. Therefore, pembrolizumab is expected to generate considerable benefits for patient lives, the healthcare system, and public.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO202
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
Oncology