OBJECTIVES: In recent years, the introduction of immuno-oncology (IO) in Italy has improved health outcomes for cancer patients and their increasing use is expected to further reduce cancer mortality rates in future years. This study aims to estimate the impact of IO introduction on incidence-adjusted mortality rates and the economic value associated with a reduction of premature mortality for melanoma, lung, and renal cancers in Italy between 2020 and 2028.

METHODS: First, a database was built integrating IQVIA sales data (2008-2021) and publicly available data sources by region, age, and sex (2008-latest year available). Second, a fixed-effects regression was implemented to estimate the relationship between incidence-adjusted cancer mortality and IO sales. Third, deaths from 2020 to 2028 were estimated in the baseline scenario, where IO sales and incidence rates from 2022 to 2028 were forecasted using an auto-regressive model and other controls were assumed constant. Fourthly, deaths estimated in the baseline scenario were compared to deaths estimated in a scenario in which IO drug sales were assumed equal to zero. Finally, the number of averted deaths were valued using the human capital method.

RESULTS: The introduction of immuno-oncology is expected to significantly reduce the number of deaths for melanoma, lung, and renal cancers by 11,202 (95% CI: 10,785-11,625), 19,490 (95% CI: 12,176-27,037), and 1,241 (95% CI: 682-1,811) respectively between 2020 and 2028, corresponding to an overall reduction in mortality of 9.9%. The reduction in mortality results in a total of €407M, €332M and 27M€ saved for indirect costs from premature mortality for melanoma, lung, and renal cancers respectively in the same period.

CONCLUSIONS: The introduction and the future increase in the use of immunotherapy drugs in Italy is expected to significantly reduce deaths and indirect costs related to premature mortality for melanoma, lung, and renal cancers in the period 2020-2028.