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Cost-effectiveness of nivolumab plus ipilimumab as first-line treatment for American patients with unresectable malignant pleural mesothelioma

Bibliographic Data

ID22069779
AuthorsZhuo-miao Ye, Zhuo‐miao Ye (Central South University), Zi-Qing Tang (Central South University), Zhe Xu (0000-0002-0186-2978, Central South University), Qin Zhou (0000-0002-7192-3887, Central South University), Huan Li (0000-0003-0910-1433, Central South University, corresponding author)
Year2022
Volume10
Pages947375-947375
Publication date2022-07-22
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2022.947375
PMID35937220
OpenAlexW4286716251
LanguageEN
References cited37

Background: The treatment paradigm of unresectable malignant pleural mesothelioma (MPM) has changed in recent years. Checkmate 743 demonstrate that nivolumab plus ipilimumab showed good clinical benefits compared with chemotherapy in the treatment of MPM. The study is aim to evaluate the cost-effectiveness of Nivolumab plus ipilimumab vs. platinum plus chemotherapy for the first-line treatment of unresectable MPM. Methods: A Markov model was developed to compare the cost and quality-adjusted life-year (QALY) of nivolumab plus ipilimumab and chemotherapy over a 10-year time horizon. Clinical efficacy and safety data were extracted from the CheckMate 743 trials. Health state utilities were obtained from published literature. Costs were collected from an US payer perspective. One-way and probabilistic sensitivity analyses were conducted to explore the impact of uncertainties on the cost-effectiveness's results. Results: In the base case analysis, the incremental healthcare costs and QALYs for Nivolumab plus Ipilimumab vs. chemotherapy are $196,604.22 and 0.53, respectively, resulting an incremental cost-effectiveness ratio (ICER) of $372,414.28/QALYs for the model cohort of patients with locally advanced or metastatic MPM. However, Probabilistic sensitivity analysis showed that there was no probability that Nivolumab plus ipilimumab was cost-effective within the fluctuation range of other model parameters in first-line in unresectable MPM. The results of one-way sensitivity analysis showed that the cost of Nivolumab was the most sensitive parameter. Conclusions: The ICER of Nivolumab plus ipilimumab is above the theoretical willingness-to-pay threshold in the U.S, which suggests that first-line nivolumab plus ipilimumab for unresectable MPM may be not a cost-effective choice

Cancer · Chemotherapy · Cost effectiveness · First line treatment · Immunotherapy · Ipilimumab · Mesothelioma · Nivolumab · Pathology · Cancer Immunotherapy and Biomarkers · Medicine · Myasthenia Gravis and Thymoma · Occupational and environmental lung diseases · Internal Medicine · Oncology

  • Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses

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    Open Access•Hyuna Sung, Adalberto M Filho et al.•CA: A Cancer Journal for Clinicians•2021

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