OBJECTIVES: A new dosing regimen of 400 mg pembrolizumab every six-weeks (Q6W), that reduces the frequency of infusions and subsequently the number of hospital visits, received a positive recommendation by the European Medicines Agency (EMA) in March 2019. The objective of this study is to evaluate the impact of the Q6W, pembrolizumab dosing schedule - for the treatment of advanced melanoma in Greece - on costs and time from both the patients’ and the hospitals’ perspective.

METHODS: A cost-minimization model was developed to determine the expected number of infusions and the associated time and monetary costs per patient with advanced melanoma treated with pembrolizumab Q6W or nivolumab and ipilimumab (nivo/ipi) combination (4 cycles of nivo/ipi every three weeks followed by nivolumab every 4 weeks). Healthcare resource utilization costs, indirect costs, travel time and hospital time per infusion were derived from the literature, whereas treatment duration was obtained from CHECKMATE-067 and KEYNOTE-006 clinical trials for nivo/ipi and pembrolizumab respectively.

RESULTS: The results indicated that from the hospital’s perspective, a patient receiving pembrolizumab Q6W will generate cost savings of €16,864.47 (incorporating drug acquisition and healthcare resource utilization costs) and time savings of 7.7 hours compared with nivo/ipi combination therapy. From the patient’s perspective, savings are estimated at €149.94 and 22 hours per patient receiving pembrolizumab Q6W compared with a patient receiving nivo/ipi combination.

CONCLUSIONS: Adopting the new six-weekly dosing schedule for pembrolizumab reduces hospital visits for drug administration which in turn could save time and resources for hospitals and increase their capacity. This is equally important for Greek patients, especially those living in remote areas or islands, for whom transportation to the nearest hospital can pose a significant burden due to Greece's unique geography.