An exploratory case study of the impact of expanding cost-effectiveness analysis for second-line nivolumab for patients with squamous non-small cell lung cancer in Canada: Does it make a difference?

Shafrin, Jason; Skornicki, Michelle; Brauer, Michelle; Villeneuve, Julie; Lees, Michael; Hertel, N.; Penrod, John R.; Jansen, Jeroen P.

doi:10.1016/j.healthpol.2018.04.008

Cited by 23 publications

(36 citation statements)

References 33 publications

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“…To our knowledge, there were only two published economic evaluations of nivolumab versus docetaxel as second-line treatments for aNSCLC, one from an Australian healthcare system perspective and the other from a broader societal perspective in Canada [31,32]. Both studies found that nivolumab was associated with substantial survival benefits at incremental cost, which was confirmed by our study.…”

Section: Discussionsupporting

confidence: 83%

Nivolumab Versus Docetaxel for Previously Treated Advanced Non-Small Cell Lung Cancer in China: A Cost-Effectiveness Analysis

et al. 2019

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Background and Objective The economic assessment of immuno-oncology agents in Chinese patients is limited despite a need for new therapies. Nivolumab is the first immune checkpoint inhibitor approved for the second-line treatment of nonsmall cell lung cancer (NSCLC) in China, and it significantly prolongs overall survival. However, considering the high cost of nivolumab, it is urgent to assess its value in China in terms of both efficacy and cost. The objective of this study was to investigate the cost-effectiveness of nivolumab vs docetaxel in the second-line setting for NSCLC patients from the Chinese healthcare system perspective. Methods A Markov model consisting of three health states, was designed to evaluate the lifetime cost and effectiveness of nivolumab vs docetaxel in the second-line treatment of NSCLC patients. Clinical data was derived from the CheckMate 078 phase III clinical trial, which included 504 patients predominantly from China. Parametric survival models to fit and extrapolate survival data were chosen based on clinical rationality, visual fit and statistical goodness-of-fit. Lifetime costs and health outcomes were calculated, and US$28,899 and $63,564 per quality-adjusted life-year (QALY) were selected as the willingness-to-pay (WTP) threshold values for general regions and affluent regions, respectively. One-way and probabilistic sensitivity analyses were undertaken to explore the robustness of the model. Additional subgroup analyses were performed. Results In base case analysis, Nivolumab yielded an additional 0.

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Section: Discussionsupporting

confidence: 83%

Nivolumab Versus Docetaxel for Previously Treated Advanced Non-Small Cell Lung Cancer in China: A Cost-Effectiveness Analysis

et al. 2019

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“…France=2 [22,31], Spain=3 [20,26,41], Portugal=1 [16], Switzerland=1 [27]) with the remaining studies based in the Americas (Canada=7 [13,17,21,23,28,38,42], USA=2 [30,37], South…”

Section: Economic Resultsmentioning

confidence: 99%

“…Records identified (total before deduplication) n = 837 appeared to use a decision tree [17], whilst the type of model used was unclear for two studies [36,38]. All studies but one [27] with model-based cost-effectiveness analyses clearly stated the time horizon, which ranged from 2 years [16][17][18][19] to 25 years [35].…”

Section: Included Eligibility Identificationmentioning

confidence: 99%

“…All but two studies [37,41] stated the perspective from which their economic analysis was conducted, with all other studies including costs from the perspective of the relevant healthcare system or funder. Ten studies reported also considered costs related to personal social services [15,18,19,24,25,29,32,34,35,38].…”

Section: Datamentioning

confidence: 99%

“…Docetaxel was the most commonly considered intervention, with only three studies not including it as an intervention of interest or comparator [23,31,39]. The majority of studies reported results in terms of cost per QALY as well as cost per LYG, with six reporting results in terms of LYG alone [13,14,23,26,37,41] and two only in terms of QALYs [38,39]. One study did not present any form of cost-effectiveness ratio, due to the interventions being indistinguishable in their benefits [21].…”

Section: Uncertainty and Assumptionsmentioning

confidence: 99%

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A Systematic Review of Economic Evaluations Assessing the Cost-Effectiveness of Licensed Drugs Used for Previously Treated Epidermal Growth Factor Receptor (EGFR) and Anaplastic Lymphoma Kinase (ALK) Negative Advanced/Metastatic Non-Small Cell Lung Cancer

et al. 2019

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Background: Non-small cell lung cancer (NSCLC) is one of the most commonly diagnosed cancers. There are many published studies of cost-effectiveness analyses of licensed treatments, but no study has compared these studies or their approaches simultaneously. Objective: To investigate the methodology used in published economic analyses of licensed interventions for previously treated advanced/metastatic NSCLC in patients without anaplastic lymphoma kinase or epidermal growth factor receptor expression. Methods: A systematic review was performed, including a systematic search of key databases (e.g. MEDLINE, EMBASE, Web of Knowledge, Cost-effectiveness Registry) limited from 01 January 2001 to 26 July 2019. Two reviewers independently screened, data extracted and quality appraised studies identified. The reporting quality of the studies was assessed by using the Consolidated Health Economic Evaluation Reporting Standards and the Philips' checklists. Results: Thirty-one published records met the inclusion criteria which corresponded to 30 individual cost-effectiveness analyses. Analytical approaches included partitioned survival models (n=14), state-transition models (n=7) and retrospective analyses of new or published data (n=8). Model structure was generally consistent, with pre-progression, post-progression and death health states used most commonly. Other characteristics varied more widely, including the perspective of analysis, discounting, time horizon, usually to align with the country that the analysis was set in. Conclusions: There are a wide range of approaches in the modelling of treatments for advanced NSCLC, however the model structures are consistent. There is variation in the exploration of sensitivity analyses, with considerable uncertainty remaining in most evaluations. Improved reporting is necessary to ensure transparency in future analyses.

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How Will You Know Whether Your Efforts to Strengthen Patient Health Are Effective and Efficient? How Will You Convince Others?

Wendel

2022

Clinical Health Psychology in Military and Veteran Settings

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An exploratory case study of the impact of expanding cost-effectiveness analysis for second-line nivolumab for patients with squamous non-small cell lung cancer in Canada: Does it make a difference?

Abstract: Broadening cost-effectiveness analysis beyond the traditional payer perspective had a significant impact on the result and should be considered in order to capture all treatment benefits and costs of societal relevance.

Cited by 23 publications

References 33 publications

Nivolumab Versus Docetaxel for Previously Treated Advanced Non-Small Cell Lung Cancer in China: A Cost-Effectiveness Analysis

Nivolumab Versus Docetaxel for Previously Treated Advanced Non-Small Cell Lung Cancer in China: A Cost-Effectiveness Analysis

A Systematic Review of Economic Evaluations Assessing the Cost-Effectiveness of Licensed Drugs Used for Previously Treated Epidermal Growth Factor Receptor (EGFR) and Anaplastic Lymphoma Kinase (ALK) Negative Advanced/Metastatic Non-Small Cell Lung Cancer

How Will You Know Whether Your Efforts to Strengthen Patient Health Are Effective and Efficient? How Will You Convince Others?

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