Cost–Utility Analysis of Nivolumab in Adjuvant Treatment of Melanoma in France
| العنوان: | Cost–Utility Analysis of Nivolumab in Adjuvant Treatment of Melanoma in France |
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| المؤلفون: | Adenike Amadi, Siguroli Teitsson, Anne-Françoise Gaudin, Stéphane Roze, Isabella Orsini, B. Bregman, François-Emery Cotté, Andriy Moshyk |
| المصدر: | Dermatology and Therapy, Vol 10, Iss 6, Pp 1331-1343 (2020) Dermatology and Therapy |
| بيانات النشر: | Springer Science and Business Media LLC, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Oncology, medicine.medical_specialty, Cost effectiveness, Subgroup analysis, Dermatology, Pembrolizumab, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Survival analysis, Original Research, Trametinib, Cost–utility analysis, business.industry, Adjuvant melanoma, Dabrafenib, Nivolumab, RL1-803, 030220 oncology & carcinogenesis, Cost-effectiveness, France, business, medicine.drug |
| الوصف: | Introduction The aim of the current study is to estimate the cost-effectiveness of adjuvant treatment with nivolumab relative to clinically relevant comparators in adult patients with melanoma with lymph node involvement or metastatic disease who have undergone complete resection from a French societal perspective. Methods The comparators were observation, low-dose interferon and pembrolizumab. A subgroup analysis was carried out in patients with BRAF mutation, adding dabrafenib plus trametinib. A three-state partitioned survival model was developed to project costs and health benefits over a 20-year time horizon. Extrapolation for recurrence-free survival (RFS) and overall survival (OS) was carried out using spline-based models. Because of the immaturity of OS data in pivotal trials for nivolumab and pembrolizumab, a predictive model of OS treatment effect based on RFS effect was developed using a correlation equation. Health state utilities and adverse events disutilities were derived from the CheckMate 238 trial and literature. Costs were estimated in 2019 euros. The model’s primary outcome was efficiency frontier. Deterministic and probabilistic sensitivity analyses were conducted to assess the robustness of results. Results Observation, low-dose interferon and nivolumab were on the efficiency frontier. The incremental cost–utility ratio of nivolumab versus low-dose interferon (closest therapy on the efficiency frontier) was €37,886/quality-adjusted life year (QALY). Probabilistic sensitivity analysis reported an 80% probability of nivolumab being a cost-effective strategy for a willingness-to-pay threshold of €52,000/QALY. In the subgroup with BRAF mutation, the efficiency frontier was not changed by the addition of dabrafenib plus trametinib. Conclusions Nivolumab is a cost-effective strategy as adjuvant treatment in adult patients with surgically resected melanoma in France. Electronic supplementary material The online version of this article (10.1007/s13555-020-00446-z) contains supplementary material, which is available to authorized users. |
| تدمد: | 2190-9172 2193-8210 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::741db0050cbb7aa502e691fc119c3e10 https://doi.org/10.1007/s13555-020-00446-z |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....741db0050cbb7aa502e691fc119c3e10 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 21909172 21938210 |
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