PCN203 Estimating the Budget and Health Impact of the PD-1/PD-L1 Inhibitor Class in Switzerland

Abstract

Immunotherapy has transformed cancer care, offering improved outcomes in a range of indications, greater quality of life, survival benefits, and regimen tolerability. However, the rapid expansion of immuno-oncology (IO) treatment options and their use has led to concerns about potentially putting healthcare budgets under strain. The objective of this study was to estimate the potential public health and budget impact of PD-1/PD-L1 inhibitors in Switzerland. Budget impact analysis and partitioned survival modelling were used to estimate key clinical and economic outcomes in a world with and without PD-1/PD-L1 inhibitors in nine high-incidence cancer types: adjuvant and metastatic melanoma, first- and second-line non-small cell lung cancer, gastric cancer, head and neck cancer, urothelial carcinoma, renal cell carcinoma, and small cell lung cancer. Outcomes were estimated over a five-year time horizon (2019-2023). Drug acquisition costs were based on publicly available information. Market share assumptions rely on internal available model estimate. Efficacy and adverse events data were taken from clinical trials. Additional 7,770 life years, 6,485 progression-free life years and 6,366 quality-adjusted life years are projected to be gained by using PD-1/PD-L1 inhibitors over a five-year period. We also expect a reduction in the number of high-grade adverse events by 9,641. In 2020, it is estimated that 22.5% of Swiss cancer medicines expenditure (CHF 220 M) will be attributable to PD-1/PD-L1 inhibitors. This accounts for an estimated 0.25% of total health care spending. The average annual budget impact of PD-1/PD-L1 inhibitors over five years is estimated to be CHF 150 million. PD-1/PD-L1 inhibitors can deliver significant survival benefits in cancer patients, with less severe side effects. The budget impact of PD-1/PD-L1 inhibitors in Switzerland is manageable but increasing usage of these treatments will require alternative measures for securing funds, such as reallocation of funds from the treatments losing exclusivity.