PCN40 Cost-Utility Analysis of Pembrolizumab Versus Platinum Based Chemotherapy As the First-LINE Treatment for Advanced and Metastatic NON-SMALL CELL LUNG Cancer (NSCLC) in UK

Abstract

To evaluate the cost-utility of pembrolizumab in comparison to platinum-based chemotherapy in the treatment of patients with advanced and metastatic non-small cell lung cancer (NSCLC) as first line treatment strategy in UK A patient level microsimulation model (PLS) was developed based on the data collected from the clinical trials (Keynote -024) and projected over 15 years. Three disease states used were: progressive disease (PD), progression free survival (PFS) and death. A rapid review was conducted to collect the cost and utility data for the relevant population. Costs related to drug acquisition, treatment administration, and clinical management of advanced lung cancer were included in the model. Drug acquisition costs were based on UK prices. Costs and outcomes were discounted at 3.5% per year. Total costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) were computed as primary indicators. One-way and probabilistic sensitivity analyses (PSA) were also performed to assess the robustness of the results. In the base case model, pembrolizumab resulted in an incremental cost of £26,145 and QALY of 1.32 comparison to platinum based chemotherapy. The resultant ICUR of pembrolizumab vs. Platinum chemotherapy was £55,628/QALY (£19,845/LY). Probability sensitivity analysis showed that pembrolizumab offered a statistically significant advantage over platinum chemotherapy to be cost-effective at a WTP threshold of £120,000/QALY in the context of the UK health care system. The results showed that pembrolizumab is a cost-effective treatment compared with platinum based chemotherapy as a first line treatment of advanced NSCLC patients in UK healthcare setting