OBJECTIVES: To analyze the cost-utility related to a pharmaceutical treatment of patients with mMCC in Taiwan, a global model was adapted to compare avelumabto conventional care regimens.

METHODS: A de novo partitioned-survival economic model was developed based on the need to capture the most clinically important outcomes for mMCC patients – OS, PFS and time on treatment informed by data from JAVELIN Merkel 200.1 The adaptation of this model took into consideration the Taiwanese National Health Insurance Administration (NHIA) perspective. Costs were identified from Taiwanese specific sources such as National Health Insurance Administration Medication Online,2 National Health Insurance Administration Medical Service Online,3 and National Health Insurance Annual Medical Expenses Reports.4 Aligned with the National Institute of Health Technology Assessment (NIHTA) recommendations,5 the results are presented as an incremental cost-effectiveness ratio (ICER) in terms of a cost per quality adjusted life year (QALY). Annual discount rates of 3% for both costs and QALYs in the base case model are also aligned with the Taiwanese reference case.

RESULTS: The ICER for avelumab versus chemotherapy was NT$925,122 for treatment-experienced mMCC patients and NT$1,021,426 for treatment-naïve mMCC patients, respectively. Both probability sensitivity analysis and deterministic sensitivity analysis confirmed the results obtained in the base-case scenarios.

CONCLUSIONS: The analysis demonstrates that avelumab is a cost-effective option vs. chemotherapy in treatment-experienced and treatment-naïve mMCC patients because results are below the general ICER threshold of 2 times the GDP per capita per QALY gained. Avelumab provides a new treatment option for mMCC patients, who otherwise are associated with very poor prognosis.