Costs and values of nivolumab in second-line cancer.

Abstract

e20629 Background: Nivolumab (Nivo) has been approved in 2nd-line treatment of melanoma, squamous (sq) and non-sq- non-small cell-lung (NSCLC), renal cell, and sq-cell of head and neck (SCCHC). Our objective was to screen and compare values (V) of Nivo in cancer. Methods: Nivo median overall survival gain over control (OS), hazard ratios (HR), doses and frequency were extracted from previously published clinical trials. Data and prices posted by the parent company were utilized. Probability of survival (PoS) was calculated as (1.0- HR). Costs (C) were computed at 4 week (w), V as 4wC/PoS (4wV) and year-C/life-year gain (C/LYG). Relative values (RV) were expressed as $100,000/C/LYG. Adverse events C were not accounted for. Results: Estimated Nivo 4wC in early 2016 was $10,021. Conclusions:HR- based platform was proposed to screen and compare V of Nivo. At 0.42 HR in melanoma and >150 day-OS in renal cell, the results suggested that Nivo was fairly-priced for its V. In non-enriched non-sq-NSCLC and SCCHN, the PD-L1 enrichment was necessary to enhance V significantly and justify C. [Table: see text]