2020
DOI: 10.1001/jamanetworkopen.2020.16144
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Cost-effectiveness of Pembrolizumab Plus Axitinib Vs Nivolumab Plus Ipilimumab as First-Line Treatment of Advanced Renal Cell Carcinoma in the US

Abstract: IMPORTANCE Checkpoint inhibitor combination therapy represents a major advance in the first-line treatment of advanced renal cell carcinoma. Pembrolizumab-axitinib and nivolumab-ipilimumab have become standard of care options after demonstrating clinical efficacy against sunitinib in separate phase 3 trials. The cost-effectiveness of these regimens is unknown. OBJECTIVE To evaluate the cost-effectiveness of pembrolizumab-axitinib and nivolumabipilimumab in the first-line treatment of advanced renal cell carcin… Show more

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Cited by 30 publications
(26 citation statements)
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“…The administration fee was based on the 2021 CMS Physician Fee Schedule, with the duration of drug infusion based on RCTs and United States Food and Drug Administration package inserts ( Centers for Medicare & Medicaid Services, 2021 ). The overall costs associated with the management of grade 3 or 4 AEs and BSC were obtained from previous literature ( Perrin et al, 2015 ; Swallow et al, 2018 ; Wan et al, 2019 ; Bensimon et al, 2020 ; Lu et al, 2020 ; Watson et al, 2020 ; Agency for Healthcare Research and Quality, US Dept of Health and Human Services (2021) ).…”
Section: Methodsmentioning
confidence: 99%
“…The administration fee was based on the 2021 CMS Physician Fee Schedule, with the duration of drug infusion based on RCTs and United States Food and Drug Administration package inserts ( Centers for Medicare & Medicaid Services, 2021 ). The overall costs associated with the management of grade 3 or 4 AEs and BSC were obtained from previous literature ( Perrin et al, 2015 ; Swallow et al, 2018 ; Wan et al, 2019 ; Bensimon et al, 2020 ; Lu et al, 2020 ; Watson et al, 2020 ; Agency for Healthcare Research and Quality, US Dept of Health and Human Services (2021) ).…”
Section: Methodsmentioning
confidence: 99%
“…Previous analysis have assessed the relationship between clinical and economic benefits of pembrolizumab, axitinib, nivolumab and ipilimumab, isolated or in combination for mRCC management, using traditional strategies such as costeffectiveness and cost-utility analyses 15,16,39,40 . In Brazil, the National Sanitary Agency (Agência Nacional de Vigilância Sanit aria -ANVISA) is responsible for registering new drugs, an exclusive task of the State that intervenes in the production-consumption relationship by establishing legal rules for granting this registration.…”
Section: Discussionmentioning
confidence: 99%
“…These studies were conducted before the advent of immunotherapy; thus, the current disease burden may be even higher. Previous studies have evaluated the cost-effectiveness of the new first-line treatment option for mRCC 15,16 , but these analyzes did not involve a cost perspective similar to that of Brazil.…”
Section: Introductionmentioning
confidence: 99%
“…Moreover, the cost needed to increase life expectancy by 0.39 years using the pembrolizumab/axitinib combination was approximately $8,61,000 per QALY gained when compared to Nivolumab plus Ipilimumab. 4,5 Also, as highlighted by Przybylski et al in your journal, 6 adding more drugs implies adding up adverse events. Higher incidences of grade 3 side effects were reported with the pembrolizumab/axitinib combination than with sunitinib alone (67% versus 62%).…”
mentioning
confidence: 97%