Impact in Health Outcomes of PD-(L)1 Inhibitors to Treat Early Stages Cancers in Switzerland
Favre-Bulle A1, Stankovic M2, Mantaian T3, Frei C2, Schaefer S2, Gabriel SS2, Sönmez D4, Aguiar-Ibáñez R5
1MSD Switzerland, Luzern, LU, Switzerland, 2MSD Switzerland, Luzern, Switzerland, 3Lumanity, Bethesda, MD, USA, 4MSD Sweden, Stockholm, Sweden, 5Merck & Co., Inc., Rahway, NJ, USA
OBJECTIVES:It is estimated that 45,000 new cases of all cancers and 17,300 deaths due to cancer occur in Switzerland every year (1). A health outcomes projection model, used in Belgium, was adapted to Switzerland to assess the health benefits of adopting PD-(L)1 inhibitors in multiple early-stage cancers. Two scenarios were developed to compare health outcomes: a) PD-(L)1 inhibitors can be used for patients with early-stage disease (world with PD-(L)1 inhibitors) vs b) PD(L)1 inhibitors are reserved for patients who develop advanced/ metastatic disease (world without PD-(L)1 inhibitors for early-stage disease).
METHODS:The health outcomes model focuses on 3 cancers: melanoma, renal cell carcinoma (RCC), and triple-negative breast cancer (TNBC). The model predicts clinical outcomes throughout the average patient pathway in weekly cycles from when they initiate neoadjuvant and/or adjuvant treatment, over a time horizon of 10 years. Clinical outcomes estimated include life-years (LY), quality-adjusted life-years (QALY), events or recurrences, active treatments for metastatic disease, adverse events (AE), and deaths. The model leverages cost-effectiveness and budget impact models developed for HTA purposes, data from pivotal trials, and Swiss specific data on projected eligible patients and market shares (2-6).
RESULTS:Of the estimated 10,659 eligible patients over 10 years (2022-2031), 9,050 are estimated to initiate neoadjuvant and/or adjuvant treatment with PD-(L)1 inhibitors for early treatment for melanoma, RCC, and TNBC. Compared to PD-(L)1s being available only in the metastatic setting, introducing PD-(L)1 inhibitors in the neoadjuvant and/or adjuvant setting for melanoma, RCC, and TNBC is anticipated to:
- Avoid 1,144 recurrences (27%).
- Prevent 1,339 (33%) active treatments in the metastatic setting.
- Avoid 605 (29%) deaths.
- Increase Life Years without recurrence by 3,416 (10%).
CONCLUSIONS:Results suggest a potential benefit in preventing metastatic disease treatments, recurrences, and in deaths in Switzerland if PD-(L)1 inhibitors are used in the early stage of cancer treatment.
Conference/Value in Health Info
Value in Health, Volume 26, Issue 11, S2 (December 2023)
Clinical Outcomes Assessment
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology