COST-ANALYSIS FOR TOXICITY MANAGEMENT IN ADVANCED SQUAMOUS NON-SMALL CELL LUNG CANCER- NIVOLUMAB VS DOCETAXEL
Author(s)
Ortega-Joaquin N1, Echave M2, Oyagüez I3, Garrido P4, Felip E5, Trigo J6, Filori M7, González García P7
1Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain, 2Pharmacoeconomics & Outcomes Research Iberia, Pozuelo de Alarcón (Madrid), Spain, 3Pharmacoeconomics & Outcomes Research Iberia, Pozuelo de Alarcón, Spain, 4H. Universitario Ramón y Cajal, Madrid, Spain, 5H. Universitario Vall d’Hebron, Barcelona, Spain, 6H. Universitario Virgen de la Victoria, Málaga, Spain, 7Bristol-Myers Squibb, Madrid, Spain
OBJECTIVES: A cost-analysis was performed to estimate the management cost for treatment-related adverse events (AE) grade 3 or 4, in patients with advanced (stages IIIb/IV) squamous non-small cell lung cancer (NSCLC) undergoing a second line (2L) therapy with nivolumab or docetaxel in Spain. METHODS: The toxicity costs(€,2016) were estimated based on published data for frequency of each AE reported on trial CheckMate-017, which were suffered in ≥5% of patients treated with nivolumab (N= 131) or docetaxel (N=129). The individual cost for each AE was calculated based on the disaggregate consumption of direct health resources, provided by an oncologists’ panel as representative of the clinical practice in Spain. The health resources included for the management of AE were: medical visits, hospitalizations, procedures, diagnostic and/or laboratory tests and surgeries. The incremental cost per patient was calculated, and an extrapolation to the eligible Spanish population (patients with advanced squamous NSCLC undergoing a 2L) was further performed. The eligible population for the next three years (2017, 2018 and 2019) was estimated with an epidemiological algorithm, considering incidence, prevalence and mortality for NSCLC reported by Globocan. Published evidence of proportion of patients with advanced squamous and those treated out of trial setting undergoing a 2L were also applied. RESULTS: The management cost (≥5%, grade 3-4 EAs) related to nivolumab (€122.17 per patient) was lower than the docetaxel one (€691.61). The incremental difference (€-569.79 per patient) was extrapolated to the 2,090, 2,119 and 2,148 eligible patients, in 2017, 2018 and 2019, respectively, given incremental cost savings for the Spanish national health system up to €1,190,860.83 in the first year, €1,207,384.74 in the second year and €1,223,908.65 in the third year. CONCLUSIONS: A 2L therapy with nivolumab for advanced squamous NSCLC could be a cost-saving strategy compared to docetaxel in terms of the associated toxicity management costs.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PCN77
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Oncology