OBJECTIVES : This study aimed to evaluate the economic effect of new administration management of pembrolizumab for the treatment of advanced or adjuvant melanoma in Italy.

METHODS : The analysis was developed considering two subsequent methodological steps: a) unit costs estimation for administration of innovative oncological drugs (drug, nurse time, physician time and preparation costs) and b) time consumption for each administration of pembrolizumab, nivolumab or ipilimumab in Italy. These data were derived from a literature review of the Italian legislation and reimbursement scheme for the Italian National Health System (NHS) while the estimated time for each administration were derived from a survey that was sent to the ten main Italian centres for the treatment of metastatic or adjuvant melanoma. Finally, the economic impact was estimated considering a standardized 1,000 patients treated with the new administration scheme with pembrolizumab every six weeks vs standard scheme administration of pembrolizumab, nivolumab and ipilimumab for a time horizon of 6 weeks.

RESULTS : the preliminary results demonstrate that the pembrolizumab Q6W scheme could generate a cost savings of Є 1.2, Є 2.2 and 3.0 million for 1,000 patients if compared with pembrolizumab Q3W, nivolumab and ipilimumab respectively. On average, 40% of these cost reductions were associated with adjuvant treatment patients.

CONCLUSIONS : The ability to reduce the admissions for drug administration in hospital due to a new therapeutic scheme of pembrolizumab, could generate and efficient management of the oncological ambulatory reducing the number of patients that have to come in hospital.