Ανάλυση κόστους-αποτελεσματικότητας του Cemiplimab σε σύγκριση με σχήμα χημειοθεραπείας σε προχωρημένο μη μικροκυτταρικό καρκίνο του πνεύμονα

Ανέστη, Ελένη

Cost-effectiveness analysis of Cemiplimab versus chemotherapy in advanced non-small cell lung cancer

Master Thesis

Author

Ανέστη, Ελένη

Date

2024

Abstract

Lung cancer is one of the most prevalent forms of cancer and remains the leading cause of cancer death worldwide. Non-small cell lung cancer (NSCLC) is the most common form of the disease, accounting for 85% of cases, and is generally considered to have a better prognosis than its counterpart, small cell lung cancer (SCLC). According to the findings of the EMPOWER-Lung 1 study of interest, Cemiplimab showed higher progression-free survival rates and better overall survival outcomes. Specifically, the estimated progression-free survival rate at 12 months was 41% for cemiplimab and 7% for chemotherapy, while the estimated probability of overall survival at 24 months was 50% for cemiplimab and 27% for chemotherapy. In addition, the median duration of response was significantly longer with cemiplimab at 16.7 months (95% CI: 12.5–22.8) compared with 6.0 months (95% CI: 4.3–6.5) with chemotherapy. Cemiplimab is a fully human monoclonal antibody that binds to the PD-1 receptor, preventing tumor cells from turning off immune cell activity. Thus, the ability of the immune system to destroy cancer cells is enhanced. On June 28, 2019, the European Medicines Agency granted cemiplimab a conditional marketing authorization, which was converted into a regular marketing authorization on July 1, 2022. Objective: This work aims to evaluate the cost and effectiveness of the drug cemiplimab versus a platinum-containing chemotherapy regimen, as first-line treatment in adult patients with advanced non-small cell lung cancer (NSCLC) (stage IIIB/IIIC or IV), whose tumors express the PD-L1 factor in at least 50%. This analysis was carried out by the National Health System. Method: To conduct the cost-effectiveness analysis, a partitioned survival model (PSM) was developed with three health states: ¨no disease progression (PFS)¨, ¨progressed disease (PD)¨ and ¨death¨. The population was designed based on the data of the EMPOWER-Lung 1 approval study and the rest of the data needed in the analysis were drawn from the foreign and Greek literature. The model followed the patients in one-month time cycles for a period of 240 months, which spans the patients' life expectancy. In addition, the annual discount rate used is 3.5%. After the basic analysis was completed, a sensitivity analysis was performed to assess the reliability of the result against the uncertainties in the model data. Results: In the main analysis, the choice of cemiplimab for the treatment of advanced NSCLC resulted in a total cost increase of €59,888.21 compared to chemotherapy. In addition, treatment with cemiplimab showed an increase in life expectancy of 1.35 years and an increase in quality-weighted life years of 0.93 compared to the chemotherapy option. From the calculation of the ratio of the cost difference and QALYs, it follows that the ICER index (incremental cost-effectiveness ratio) is €64,657.57/QALY.

Postgraduate Studies Programme

Οικονομικά και Διοίκηση της Υγείας

Department

Σχολή Οικονομικών, Επιχειρηματικών και Διεθνών Σπουδών. Τμήμα Οικονομικής Επιστήμης

Number of pages

105

Language

Greek

URI

https://dione.lib.unipi.gr/xmlui/handle/unipi/16749
http://dx.doi.org/10.26267/unipi_dione/4171

Collections

Τμήμα Οικονομικής Επιστήμης

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Except where otherwise noted, this item's license is described as
Αναφορά Δημιουργού-Μη Εμπορική Χρήση-Όχι Παράγωγα Έργα 3.0 Ελλάδα