BUDGET IMPACT ANALYSIS OF AVELUMAB IN PATIENTS WITH METASTATIC MERKEL CELL CARCINOMA IN THE US
Author(s)
Bharmal M1, D'Angelo SP2, Phatak H3
1Merck KGaA, Darmstadt, Germany, 2Memorial Sloan Kettering Cancer Center, New York, NY, USA, 3EMD Serono, Billerica, MA, USA
OBJECTIVES: The aim of this research was to estimate the budget impact of avelumab (BAVENCIO®) as a treatment option for patients with previously treated (2L+) and untreated (1L) metastatic Merkel cell carcinoma (mMCC) in the United States of America (US). METHODS: A budget impact model with a five-year horizon was developed. Comparators were pembrolizumab and chemotherapies recommended for use in the eligible population. It is anticipated that avelumab and pembrolizumab, both immune-oncology agents (IOs), are expected to partially replace chemotherapies (chemotherapy share 1L: 47% to 35%; 2L+: 62% to 60%). Duration of treatment was estimated based on the clinical study results for avelumab (JAVELIN Merkel 200); an observational study of patients with mMCC treated with chemotherapies, and evidence from a single arm study for pembrolizumab (NCT02267603). Costs included drug acquisition and administration, monitoring, adverse events, and transport costs. All inputs were validated by practicing clinician opinion. RESULTS: Considering a hypothetical health plan with 100 million members in 2017, 294 patients were estimated to have mMCC, with mMCC confirmed in an estimated 77 patients eligible for treatment with avelumab as 1L treatment and 23 as 2L treatment. The budget impact of avelumab was estimated to be US$0.0006 per member per year (PMPY) in Y1. Over 5 years the total budget impact was estimated to be US$0.013 PMPY. A slower uptake of IO agents (e.g. if their market share remained at 53% in 1L and 38% in 2L+) would result in a 5-year budget impact of US$0.011 PMPY. On the contrary, if IO agents completely replaced chemotherapies the impact would be US$0.022 PMPY. CONCLUSIONS: MCC is a rare condition with a poor prognosis and patients stand to benefit greatly from new innovative immunotherapies. The addition of avelumab as a treatment option would likely result in a very modest increase in healthcare expenditure.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCN70
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Oncology