OBJECTIVES: Cancer incidence and mortality have been increasing both globally and in Greece. The burden of cancer in Greece is significant, with 64,530 new cancer cases and 33,166 deaths attributed to cancer annually. The aim of this study is to assess and quantify the health benefits of including PD-(L)1 inhibitors in four early-stage cancer indications which have a meaningful burden both in incidence and mortality in Greece: melanoma (Stage IIB/C&III), renal cell carcinoma (RCC), and triple-negative breast cancer (TNBC).

METHODS: Markov models were used to predict clinical outcomes and costs throughout the average patient pathway from 2023-2033. Tumors studied include melanoma (Stage IIB/C&III), RCC and, TNBC. The model includes two scenarios: 1) using PD-(L)1 inhibitors for patients with early-stage and metastatic disease versus 2) reserving PD(L)1 inhibitors for advanced/metastatic cancers. The model included efficacy data from clinical trials, Greek data on market shares, projected eligible patients and respective costs. Estimated outcomes at the national level include events or recurrences, active treatments for metastatic disease, total deaths, life-years (LY), quality-adjusted life-years (QALY), overall costs, costs per heath state.

RESULTS: Results indicate that the introduction of PD-(L)1 inhibitors in the neoadjuvant and/or adjuvant setting compared to PD-(L)1s being available only in the metastatic setting, is expected to yield: 1,772(-25%) avoided recurrences, 881 (-24%) total avoided deaths, an increase in LY without recurrence by 5,556 (+11%), 2363 additional QALY’s (+4%), 1,722 prevented active treatments in the metastatic setting(-27%). A 35% increase in costs has been estimated throughout the 10-year time horizon.

CONCLUSIONS: Results indicate that neoadjuvant/adjuvant treatments provide a significant benefit to cancer patients by preventing disease recurrences, treatments in the metastatic setting and deaths. From the perspective of the healthcare payer, benefits arise by avoiding later lines cost; at a manageable additional investment compared to the benefits in patient outcomes.