OBJECTIVES: Advanced melanoma is an aggressive disease accounting for 90% of skin cancer-related deaths. The aim of this study was to compare costs associated with nivolumab plus ipilimumab combination regimen (N+I), N monotherapy and I monotherapy.

METHODS: Individual patient-level trial data for healthcare resource utilisation (HCRU) of European patients enrolled in the CheckMate 067 trial were used to derive costs associated with treatment with N+I, N, and I. Unit costs for each country were applied to the HCRU data for the first year of the trial and aggregated to determine the cost for each patient. The model developed by authors counted cost of: core regimen dosage and administration; concomitant medication; subsequent melanoma treatments; diagnostic and procedures; laboratory tests, hospitalisations and surgeries. The average cost per patient per month was calculated using the trial population censored at each month.

RESULTS: After 1-year of follow-up the total treatment costs for each regimen for the average patient enrolled in the CheckMate 067 trial for the N+I, N, and I arms were: €101,419, €109,496 and €124,901 in Portugal; €91,492, €72,807 and €91,283 in Greece; €121,949, €100,836 and €126,670 in Spain; and NOK1,187,223, NOK978,723 and NOK1,244,794 in Norway. Though N+I treatment resulted in higher drug costs, it also resulted in savings in subsequent melanoma treatment and reduced costs in surgeries. Furthermore, patients in the N arm had higher administration and lab costs. Drug costs contribute most to the total costs (N+I 68-84%; N 39-63%; I 42-62%) followed by subsequent treatment (N+I 5-8%; N 24-33%; I 26-39%), lab and hospitalisation costs (N+I 6-18%; N 4-15%; I 5-16%). Data from 28 months of follow-up in CheckMate 067 will be presented to provide additional information.

CONCLUSIONS: The higher initial investment for first line treatment with N+I compared to monotherapies is partially compensated by a lower subsequent therapies cost.