Cost Estimate of Immune-Related Adverse Reactions Associated with Innovative Treatments of Metastatic Melanoma

Francesco S Mennini, Chiara Bini, Andrea Marcellusi, Michele Del Vecchio

Research output: Contribution to journalReview article

Abstract

BACKGROUND AND OBJECTIVE: Immuno-oncology therapies represent a new treatment opportunity for patients affected by metastatic melanoma. The purpose of this study was to estimate the costs of immune-related adverse events (irAEs) associated with the new anti-PD1 immuno-oncology therapies, with the anti-CTLA-4 immuno-oncology therapy and with the combined therapy (CTLA4 + anti-PD1) in patients affected by metastatic melanoma.

MATERIALS AND METHODS: A probabilistic cost-of-illness (COI) model was developed to estimate the management costs of grade ≥ 3 adverse events associated with the new anti-PD1 therapies (pembrolizumab and nivolumab), the anti-CTLA-4 therapy (ipilimumab) and the combined therapy CTLA4 + anti-PD1 (nivolumab + ipilimumab) for the treatment of patients with metastatic melanoma from the National Health Service (NHS) perspective in Italy. Identification of the epidemiological and cost parameters was carried out through a systematic literature review (SLR). Univariate and probabilistic sensitivity analyses were performed to account for uncertainty and variation in the model results.

RESULTS: The model estimated a cost associated with the management of grade ≥ 3 immune-related adverse events in patients with metastatic melanoma equal to €176.2 (95% CI 63.5-335.0) for anti-CTLA-4 therapy, €48.6 (95% CI 40.1-58.5) for the new anti-PDI therapies and €276.8 (95% CI 240.4-316.2) for the combined therapy. Among the innovative therapies for the considered metastatic melanoma, the combined therapy was the most expensive innovative treatment in terms of event management of immune-related grade ≥ 3 adverse events.

CONCLUSION: This study may represent a useful tool to understand the economic burden associated with the management of irAEs associated with patients affected by metastatic melanoma.

Original languageEnglish
Pages (from-to)967-976
Number of pages10
JournalClinical Drug Investigation
Volume38
Issue number10
DOIs
Publication statusPublished - Oct 2018

Keywords

  • Antibodies, Monoclonal, Humanized/administration & dosage
  • Antineoplastic Agents, Immunological/administration & dosage
  • CTLA-4 Antigen/administration & dosage
  • Costs and Cost Analysis/methods
  • Drug-Related Side Effects and Adverse Reactions/economics
  • Humans
  • Ipilimumab/administration & dosage
  • Italy/epidemiology
  • Melanoma/drug therapy
  • Nivolumab/administration & dosage
  • Therapies, Investigational/adverse effects

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