OBJECTIVES

Pembrolizumab and nivolumab are monoclonal anti-programmed cell death-1 (PD-1) antibodies currently approved for the treatment of multiple oncology/hematology indications. In March of 2019, the European Medicines Agency (EMA) recommended approval for an alternative dose and dosing schedule of 400 mg every 6 weeks (Q6W) across all adult indications for pembrolizumab monotherapy, which effectively halves the number of in-hospital admissions required by 200 mg every 3 weeks (Q3W) dosing regimen. The objective of this analysis was to estimate difference in the per-patient costs and time from the hospital and the patient perspective by comparing nivolumab 480 mg every 4 weeks regimen (Q4W) to the pembrolizumab Q6W.

METHODS

The Excel model was structured to calculate the costs and time associated with infusion of pembrolizumab Q6W or nivolumab Q4W over the average course of treatment for adjuvant and advanced melanoma patients eligible for treatment. Default treatment duration values were extracted from publications based on the results of the clinical trials. The model was populated using Swedish inputs and cost were expressed in 2020 Swedish Krona (SEK).

RESULTS

By using pembrolizumab Q6W savings per adjuvant melanoma patient are estimated to 33,570 SEK and 14 hours from the hospital perspective and 3,894 SEK and 17.8 hours from the patient perspective. For advanced melanoma, hospitals are estimated to save 20,142 SEK and 8.5 hours, per patient, while it is estimated that the patient could save 2,356 SEK and 10.7 hours.

CONCLUSIONS

Q6W pembrolizumab was associated with decreased use of time and money, from both the hospital and the patient perspectives, when compared to nivolumab Q4W.