Cost-Effectiveness of Docetaxel Versus Immune Checkpoint Inhibitors as Treatment for Advanced/Metastatic Non-Small Cell Lung Cancer: A Targeted Literature Review

Author(s)

Bruce Wang, PhD1, Philip Li, MD2, Jorge F. Nino de Rivera Guzman, MSc3.
1Novocure, Portsmouth, NH, USA, 2Novocure, Baar, Switzerland, 3Health Economy specialist, Novocure, Glendale, CO, USA.

Presentation Documents

OBJECTIVES: To conduct a targeted review of cost-effectiveness studies comparing docetaxel with Immune Checkpoint Inhibitors (ICIs) for advanced/metastatic non-small cell lung cancer (NSCLC).
METHODS: A comprehensive targeted search was performed on PubMed using relevant keywords such as "non-small cell lung cancer," "cost-effectiveness," "advanced," and "docetaxel" to identify pertinent studies involving ICIs. Retrieved papers were thoroughly reviewed to extract essential data, including interventions, comparators, model details, incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY), and ICER per life year gained (LYG). Only English-language studies published within the last 10 years were included.
RESULTS: A comprehensive analysis identified seven relevant studies evaluating the cost-effectiveness of key checkpoint inhibitors—Pembrolizumab, Nivolumab, and Atezolizumab—all focused on advanced/metastatic non-small cell lung cancer (NSCLC). Geographically, three studies were conducted from the perspective of the United States, three from China, one from France, and one from Switzerland. Among the evaluated drugs, Nivolumab demonstrated an incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) ranging from $72,127 to $200,698. Atezolizumab reported an ICER value of €104,835, while Pembrolizumab demonstrated ICER values ranging from $107,846 to $168,619. In terms of cost per life years gained, Nivolumab ranged from $37,243 to $81,294, while Pembrolizumab was estimated at $135,552. The primary model drivers influencing cost-effectiveness outcomes included the cost of intervention, chemotherapy expenses, adverse event (AE) costs, terminal care costs, and best supportive care.
CONCLUSIONS: ICIs have introduced innovative therapeutic options for advanced/metastatic NSCLC, but their ICERs often exceed commonly accepted thresholds, limiting their economic viability compared to docetaxel. This highlights the need to either improve clinical outcomes or reduce costs to enhance affordability and support wider adoption in healthcare systems.

Conference/Value in Health Info

2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan

Value in Health Regional, Volume 49S (September 2025)

Code

RWD225

Topic Subcategory

Health & Insurance Records Systems

Disease

SDC: Oncology

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