Budget Impact (BI) of First-Line (1L) Cemiplimab Monotherapy for Advanced Non-Small Cell Lung Cancer (aNSCLC) with Programmed Cell Death-Ligand 1 (PD-L1) ≥50% in a Large US Health Plan: An Updated Analysis


Quek RGW1, Theriou C2, Smare C2, Keeping S3, Xu Y1, Konidaris G4, LaFontaine PR5, Harnett J1
1Regeneron Pharmaceuticals, Inc, Tarrytown, NY, USA, 2Precision HEOR, London, UK, 3Precision HEOR, Vancouver, BC, Canada, 4Sanofi, Reading, UK, 5Sanofi, Cambridge, MA, USA

Objectives: Cemiplimab monotherapy significantly improved overall survival versus chemotherapy in 1L aNSCLC with PD-L1≥50%. Here, we estimate the BI of introducing cemiplimab monotherapy in the US from the healthcare payer’s perspective using updated market share data indicating higher usage of immunotherapy (IO)+chemotherapy and a lower share of IO monotherapy compared to prior analyses in the high PD-L1 population.

Methods: Patients with aNSCLC and PD-L1≥50% without EGFR or ALK mutations were modeled over 3-years. Duration of treatment (DoT) inputs were based on median progression-free survival from published literature. Cemiplimab uptake, projected to increase from 1% (Year 1) to 6% (Year 2) to 10% (Year 3), was displaced from pembrolizumab monotherapy (100%). Other treatments were assumed to remain the same based on market share data over the past 3-years. List price per dose was lower for cemiplimab versus pembrolizumab (ProspectoRx database, November 2021). Adverse event costs were estimated using the 2017 Healthcare Cost and Utilization Project database and event-specific ICD-10 codes, and inflation-adjusted to 2021 costs. Disease management costs were per Centers for Medicare and Medicaid Services data. In univariate sensitivity analyses, inputs were varied by ±20% to model the impact on total 3-year incremental costs.

Results: In a hypothetical 1 milion-member US healthcare plan, ~60 were eligible to receive cemiplimab monotherapy treatment for 1L aNSCLC with PD-L1≥50% in Year 1. The average incremental cost over 3-years was –$0.0029 per-member per-month. The 3-year cumulative incremental BI of introducing cemiplimab monotherapy was –$106,172, representing approximately 0.4% saving in US healthcare payer’s budget. The analysis was most sensitive to changes to DoT; changes to all other inputs had ≤20% impact.

Conclusions: Cemiplimab monotherapy is likely associated with US healthcare payer budgetary savings for treatment of 1L aNSCLC with PD-L1≥50%.

Conference/Value in Health Info

2022-05, ISPOR 2022, Washington, DC, USA




Economic Evaluation, Study Approaches

Topic Subcategory

Budget Impact Analysis, Decision Modeling & Simulation


Drugs, Oncology

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