POSA128 Cost-Effectiveness Analysis of Avelumab Plus Best Supportive Care (BSC) vs BSC Alone as a First-Line (1L) Maintenance Treatment for Patients With Locally Advanced or Metastatic Urothelial Carcinoma in Taiwan

Chang, WC; Xiao, Yan; Lin, AY; Su, Po‐Jung; Goh, Connie; Wu, Eric Q.; Liu, Kunling; Chou, Patrick; Kuo, Kaitlin; Palencia, R.; Chang, Jane; Kearney, Mairead; Kapetanakis, Venediktos; Benedict, Ágnes

doi:10.1016/j.jval.2021.11.271

Cited by 2 publications

(4 citation statements)

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“…These findings are also consistent with ICERs for other country models for avelumab 1L maintenance therapy plus BSC in patients with mUC in the US [50] and China [51], which ranged between $102,365/QALY and $241,610/QALY. Similar incremental QALYs and LYs were also reported for the United Kingdom, Finland, and Taiwan [52][53][54]. Avelumab 1L maintenance therapy plus BSC compared with BSC alone was associated with improved life expectancy with incremental QALYs and LYs gained of 0.67 and 0.77, respectively.…”

Section: Plos Onesupporting

confidence: 70%

Cost-effectiveness of avelumab first-line maintenance therapy for adult patients with locally advanced or metastatic urothelial carcinoma in France

Porte,

Granghaud,

Chang

et al. 2024

PLoS ONE

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Background This study evaluated the cost-effectiveness of avelumab first-line (1L) maintenance therapy plus best supportive care (BSC) versus BSC alone for adults with locally advanced or metastatic urothelial carcinoma (la/mUC) that had not progressed following platinum-based chemotherapy in France. Methods A three-state partitioned survival model was developed to assess the lifetime costs and effects of avelumab plus BSC versus BSC alone. Data from the phase 3 JAVELIN Bladder 100 trial (NCT02603432) were used to inform estimates of clinical and utility values considering a 10-year time horizon and a weekly cycle length. Cost data were estimated from a collective perspective and included treatment acquisition, administration, follow-up, adverse event–related hospitalization, transport, post-progression, and end-of-life costs. Health outcomes were measured in quality-adjusted life-years (QALYs) and life-years gained. Costs and clinical outcomes were discounted at 2.5% per annum. Incremental cost-effectiveness ratios (ICERs) were used to compare cost-effectiveness and willingness to pay in France. Uncertainty was assessed using a range of sensitivity analyses. Results Avelumab plus BSC was associated with a gain of 2.49 QALYs and total discounted costs of €136,917; BSC alone was associated with 1.82 QALYs and €39,751. Although avelumab plus BSC was associated with increased acquisition costs compared with BSC alone, offsets of −€20,424 and −€351 were observed for post-progression and end-of-life costs, respectively. The base case analysis ICER was €145,626/QALY. Sensitivity analyses were consistent with the reference case and showed that efficacy parameters (overall survival, time to treatment discontinuation), post-progression time on immunotherapy, and post-progression costs had the largest impact on the ICER. Conclusions This analysis demonstrated that avelumab plus BSC is associated with a favorable cost-effectiveness profile for patients with la/mUC who are eligible for 1L maintenance therapy in France.

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Section: Plos Onesupporting

confidence: 70%

Cost-effectiveness of avelumab first-line maintenance therapy for adult patients with locally advanced or metastatic urothelial carcinoma in France

Porte,

Granghaud,

Chang

et al. 2024

PLoS ONE

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“…A global de novo partitioned survival model, handled in Microsoft Excel, of patients with la/mUC without disease progression following 1L platinum‐containing chemotherapy was built for adaptation to Taiwan. 17 , 18 , 19 This model presented the analyses from the Taiwan payer perspective. This manuscript was written based on the ISPOR Consolidated Health Economic Evaluation Reporting Standards.…”

Section: Methodsmentioning

confidence: 99%

“…This research was financially supported by the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945), and was previously conducted under an alliance between the healthcare business of Merck KGaA, Darmstadt, Germany and Pfizer. Part of this analysis was previously published in a poster presented at ISPOR Europe, 2021: Reference [ 17 ].…”

Section: Acknowledgmentsmentioning

confidence: 99%

“…A global partitioned survival model was adapted for Taiwan, and the cost-effectiveness of avelumab plus BSC versus BSC alone was estimated in terms of the incremental costeffectiveness ratio (ICER), life years (LYs), and quality-adjusted LYs Excel, of patients with la/mUC without disease progression following 1L platinum-containing chemotherapy was built for adaptation to Taiwan. [17][18][19] This model presented the analyses from the Taiwan payer perspective. This manuscript was written based on the ISPOR Consolidated Health Economic Evaluation Reporting Standards.…”

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confidence: 99%

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A cost‐effectiveness analysis of avelumab plus best supportive care versus best supportive care alone as first‐line maintenance treatment for patients with locally advanced or metastatic urothelial carcinoma in Taiwan

Su,

Xiao,

Lin

et al. 2023

Cancer Reports

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BackgroundPatients with locally advanced or metastatic urothelial carcinoma have limited treatment options and a poor prognosis. The JAVELIN Bladder 100 trial showed that avelumab as first‐line maintenance plus best supportive care significantly prolonged overall survival and progression‐free survival versus best supportive care alone in patients with locally advanced or metastatic urothelial carcinoma that had not progressed with first‐line platinum‐containing chemotherapy.AimsWe assessed whether avelumab plus best supportive care is a cost‐effective treatment option versus best supportive care alone in this patient group in Taiwan.Methods and ResultsA partitioned survival model was used to estimate the costs and effects of avelumab plus best supportive care versus best supportive care alone over a 20‐year time horizon from the perspective of Taiwan's National Health Insurance Administration. Patient‐level data from JAVELIN Bladder 100 on efficacy, safety, utility, and time on treatment were analyzed to provide parameters for the model. Log‐normal and Weibull distributions were used for overall survival and progression‐free survival, respectively. Costs of healthcare resources, drug acquisition, adverse events, and progression were identified through publicly available data sources and clinician interviews. The model estimated total costs, life years, and quality‐adjusted life years. In the modeled base case, avelumab plus best supportive care increased survival versus best supportive care alone by 0.79 life years (2.93 vs. 2.14) and 0.61 quality‐adjusted life years (2.15 vs. 1.54). The incremental cost‐effectiveness ratio for avelumab plus best supportive care versus best supportive care alone was NT$1 827 680. Most (78%) of the probabilistic sensitivity analyses fell below three times the gross domestic product per capita. Scenario analysis indicated that life year and quality‐adjusted life year gains were most sensitive to alternative survival extrapolations for both avelumab plus best supportive care and best supportive care alone.ConclusionAvelumab first‐line maintenance therapy combined with best supportive care was determined as a cost‐effective treatment strategy for patients in Taiwan diagnosed with locally advanced or metastatic urothelial carcinoma that had not progressed with platinum‐containing chemotherapy.

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POSA128 Cost-Effectiveness Analysis of Avelumab Plus Best Supportive Care (BSC) vs BSC Alone as a First-Line (1L) Maintenance Treatment for Patients With Locally Advanced or Metastatic Urothelial Carcinoma in Taiwan

Cited by 2 publications

References 0 publications

Cost-effectiveness of avelumab first-line maintenance therapy for adult patients with locally advanced or metastatic urothelial carcinoma in France

Cost-effectiveness of avelumab first-line maintenance therapy for adult patients with locally advanced or metastatic urothelial carcinoma in France

A cost‐effectiveness analysis of avelumab plus best supportive care versus best supportive care alone as first‐line maintenance treatment for patients with locally advanced or metastatic urothelial carcinoma in Taiwan

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