PharmacoEconomics Open最新文献

{"title":"COVID-19 Vaccine Preferences in China: A Comparison of Discrete Choice Experiment and Profile Case Best-Worst Scaling.","authors":"Enxue Chang, Yanni Jia, Xiaoying Zhu, Lunan Wang, Ying Yan, Kejun Liu, Weidong Huang","doi":"10.1007/s41669-025-00559-1","DOIUrl":"10.1007/s41669-025-00559-1","url":null,"abstract":"<p><strong>Objectives: </strong>Little is known about the diversity of residents' preferences for COVID-19 vaccines during the time when COVID-19 management was downgraded in China. This study aims to investigate these preferences using discrete choice experiment (DCE) and profile case best-worst scaling (BWS-2), and to assess the concordance between these two methods.</p><p><strong>Methods: </strong>Chinese residents recruited for the online survey were asked to evaluate COVID-19 vaccine profiles through both DCE and BWS-2 from April to July 2023. Attributes included effectiveness, duration of protection, risk of severe adverse events (degree), the total out-of-pocket (OOP) cost, brand, and the vaccination method. We utilized conditional regression and mixed logit regression models to estimate the preference levels for potential attributes. To assess preference concordance between the two methods, re-scaling and the Spearman correlation test were used. Additionally, subgroup analysis was conducted to determine the most suitable method for different population groups, categorized by vaccine hesitancy and risk level.</p><p><strong>Results: </strong>A total of 438 (71.22%) respondents were included. A similar pattern was found in the DCE and BWS-2 methods, with the respondents having a strong preference for 90% vaccine effectiveness. However, the methods diverged in other preferences; DCE favored domestic brands and low severe adverse event risk, while BWS-2 preferred moderate risk and three years of protection. Concordance assessment, including Spearman's correlation and linear regression, showed no significant correlation and poor concordance between the methods, underscoring these differences. Preference heterogeneity is revealed among different groups; however, effectiveness remained the most important attribute for all subgroups of the population. Oral vaccination was the preferred option for both the vaccine-hesitant and high-risk groups.</p><p><strong>Conclusion: </strong>This study offers new insights into the varying preferences for COVID-19 vaccines among Chinese residents following the downgrading of pandemic management measures. The findings underscore the need for diverse strategies in vaccine policy design. Special emphasis should be placed on vaccine attributes that align with public priorities, such as high effectiveness and low risk levels, to enhance vaccine uptake.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"399-413"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"So Many Choices, So Little Value: Potential Savings from Selecting Cost-Effective Proton Pump Inhibitors.","authors":"Hye-Young Kwon","doi":"10.1007/s41669-025-00563-5","DOIUrl":"10.1007/s41669-025-00563-5","url":null,"abstract":"<p><strong>Background: </strong>Given that Korea lacks measures to promote cost-effective prescribing, this study investigated the efficiency of prescribers' decision-making when faced with the choice of 398 products containing 15 proton pump inhibitors (PPI).</p><p><strong>Objective: </strong>This study aimed to explore PPI prescribing patterns in ambulatory care over 10 years and elucidate prescribers' practices. Further analysis was conducted to estimate the achievable potential savings, assuming that the recommendation of first-choice drugs is based on the rational use of medicines.</p><p><strong>Methods: </strong>Retrospective PPI prescribing data from the ambulatory sector pertaining to medical services provided to the entire South Korean population from 2013 to 2022 were extracted from the Korean National Health Information Database; the data were analyzed to identify annual trends in PPI spending and utilization volume according to defined daily doses (DDDs). Unit price per DDD was calculated, and a preferred cost-effective choice with identical efficacy and safety profile was selected among PPIs. The potential savings were then simulated using Dirichlet distribution.</p><p><strong>Results: </strong>In ambulatory care, PPI drug costs increased by 13.0% per annum over 10 years. The preferred substances were esomeprazole (31.6%), rabeprazole (23.2%), and tegoprazan (16.5%), which are among the most expensive PPIs. However, the most cost-effective substance was dexlansoprazole (South Korean won [KRW] 522.7; standard deviation [SD] = 72.2; and median = 583). If dexlansoprazole is recommended as the first-choice PPI in the Korean context, the estimated cost savings would be 404.24 billion KRW, equivalent to 47.0% of the current PPI spending in ambulatory care.</p><p><strong>Conclusions: </strong>This study identified opportunities for substantial cost savings related to PPI prescribing. Guided decision-making toward cost-effective PPI prescribing would increase the efficiency of prescribing and the sustainability of the healthcare system.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"461-469"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do We Understand Unmet Need? A Proposal to Use Length-Of-Life Equivalent (LOLE) as a Patient-Centric Measure of Unmet Need.","authors":"Kevin Marsh, Robert F Reynolds, Linda Nelsen, Stephen Watt, Omar A Escontrías, Brett Hauber","doi":"10.1007/s41669-025-00560-8","DOIUrl":"10.1007/s41669-025-00560-8","url":null,"abstract":"<p><p>Many decision-makers have emphasized the importance of leveraging patient experience data to measure unmet need. However, there is no standardized, patient-centric unmet need measure that formalizes how the value judgements inherent in such a measure should be made. Several initiatives have identified measuring unmet need as one of the primary uses of patient preference data. After reviewing how decision-makers define unmet need, this paper proposes that a thresholding method could be used to generate a standardized, patient-centric, disease-agnostic, quantitative unmet need estimate, length of life equivalent (LOLE). LOLE would address some of the limitations of current methods, including facilitating capture of the impact of disease beyond health-related quality of life, and being more sensitive to the impact of a disease on patients. However, the acceptability of LOLE raises questions for decision-makers, including: Is length of life equivalence the best common metric in which to express unmet need? Is it appropriate to rate a disease as having no unmet need if patients are unwilling to trade off life expectancy for improvements in their quality of life? Can LOLE be estimated for more complex disease profiles? Is thresholding the appropriate method to use to estimate LOLE? How should LOLE be integrated into decision-making, including the level of LOLE that defines different levels of unmet need? Further work could usefully address these questions with decision-makers.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"341-350"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Utility Analysis of LifeVest® in Post-Myocardial Infarction Patients at Risk of Sudden Cardiac Death in England.","authors":"Vasileios Kontogiannis, Farai Goromonzi, Brigitte Both, Frank Semrau, Michael Branagan-Harris, Jowan Atkinson, Paul R Roberts, Mehdi Javanbakht","doi":"10.1007/s41669-024-00553-z","DOIUrl":"10.1007/s41669-024-00553-z","url":null,"abstract":"<p><strong>Background: </strong>Patients with a left ventricular ejection fraction ≤ 35% are at increased risk of sudden cardiac death (SCD) within the first months after a myocardial infarction (MI). The wearable cardioverter defibrillator (WCD) is an established, safe and effective solution which can protect patients from SCD during the first months after an MI, when the risk of SCD is at its peak. This study aimed to evaluate the cost-effectiveness of WCD combined with guideline-directed medical therapy (GDMT) compared to GDMT alone, after MI in the English National Health Service (NHS).</p><p><strong>Methods: </strong>A multi-state Markov model, with a hypothetical cohort of 1000 patients, was developed to evaluate WCD + GDMT compared with GDMT alone, over a lifetime time horizon. Model input parameters were obtained from the pivotal randomised controlled trial and literature. The outcomes were costs and quality-adjusted life-years (QALYs), discounted at 3.5% annually, with overall results presented as an incremental cost-effectiveness ratio (ICER).</p><p><strong>Results: </strong>The cost-effectiveness analysis demonstrated that WCD + GDMT is potentially a cost-effective option with an ICER of £23,024 per QALY gained, which is in the acceptable willingness to pay threshold (WTP) range of £20,000-£30,000 set by the National Institute for Health and Care Excellence (NICE) in England. Results of probabilistic sensitivity analysis (PSA) indicated that WCD + GDMT has 89.3% and 23% probability of being cost-effective at WTP thresholds of £30,000 and £20,000, respectively.</p><p><strong>Conclusions: </strong>Implementation of WCD in patients post-MI is potentially a cost-effective use of resources for the NHS and improves clinical outcomes amongst adherent patients and in circumstances where implantable cardioverter defibrillators are not indicated by the guidelines.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"301-312"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Economic Modelling of Improved Behavior in Insulin Injection Technique in Belgium.","authors":"Kristof Theys, Sofie Vermander, Lieven Annemans, Christophe De Block, Michel P Hermans, Imke Matthys, Frank Nobels, Trung Nguyen, Vanessa Preumont, Katerina Zakrzewska, Frank Vanderdonck","doi":"10.1007/s41669-024-00547-x","DOIUrl":"10.1007/s41669-024-00547-x","url":null,"abstract":"<p><strong>Background: </strong>Adequate insulin injection technique (IIT) is crucial to optimize the efficacy of diabetes therapy. Widespread non-practice of injection-site rotation and frequent reuse of insulin pen needles (PN) promote high rates of lipohypertrophy (LH) among people living with diabetes (PwD). LH is associated with increased insulin requirement and suboptimal insulin absorption leading to worsened glycemic control and increased risk for hypoglycemia. Avoiding out-of-the-pocket patient costs of PN could reduce PN reuse, thereby limiting its contribution to LH occurrence.</p><p><strong>Objectives: </strong>A model was developed to compute the impact of a behavior shift in reuse on clinical and economic outcomes for type 1 and insulin-treated type 2 diabetes populations in Belgium.</p><p><strong>Methods: </strong>Patient populations were characterized by treatment-specific characteristics and grouped by their frequency of PN replacement. The intervention was modelled to cause a change in reuse frequency, with the effects propagating downstream of the model. Model and input parameters were based on literature research and expert opinions from a Delphi panel, since available data was found to be limited, incomplete or inconsistent and assumptions were needed.</p><p><strong>Results: </strong>Using the current situation as comparator, this analysis showed a reduction of healthcare expenditures following an improvement in IIT. Considering a 5-year time horizon, this study yields potential savings of 52.6 million euros (28.1-77.9 million euros) when 55% of PwD improve PN reuse behavior.</p><p><strong>Conclusion: </strong>Our model shows that even in an era of technological advances and established diabetes care, lack of adherence to correct IIT has an important impact on economic and health outcomes of PwD in Belgium.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"259-270"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Complications and Healthcare Resource Utilization Associated with Conventional Management of Sickle Cell Disease with Recurrent Vaso-occlusive Crises and Transfusion-Dependent β-Thalassemia in Germany.","authors":"Chuka Udeze, Nanxin Li, Colin Kunzweiler, Jessica Baldwin, Petra Tuzin, Sebastian Dietmar Zingel, Céline Vetter, Silvia Dombrowski, Elena Georgiadou-Schmidt, Aranzazu Alba, Roland Meisel","doi":"10.1007/s41669-024-00550-2","DOIUrl":"10.1007/s41669-024-00550-2","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to describe clinical complications and healthcare resource utilization (HCRU) among patients with sickle cell disease (SCD) with recurrent vaso-occlusive crises (VOCs) and patients with transfusion-dependent β-thalassemia (TDT) in Germany.</p><p><strong>Methods: </strong>The Betriebskrankenkasse (BKKs) Database was used to identify patients with SCD or TDT. To be eligible for inclusion, patients with SCD were required to have ≥ 2 VOCs/year in any two consecutive years and ≥ 12 months of available data before and after the index date (second VOC in the second consecutive year). Patients with TDT were required to have ≥ 8 red blood cell transfusions (RBCTs) in any 12-month period and ≥ 12 months of available data after the index date (first RBCT). Clinical and HCRU outcomes were analyzed during follow-up.</p><p><strong>Results: </strong>Overall, 84 patients with SCD with recurrent VOCs and 68 patients with TDT were identified in the BKKs database. Among patients with SCD with recurrent VOCs, the most prevalent complications were retinopathy (45.2%), multisystem organ disease/failure (40.5%), and mental health complications (31.0%); among patients with TDT, they were endocrine (69.1%) and cardiopulmonary (55.9%) complications and malignancies (44.1%). Patients with SCD experienced a mean of 4.0 (standard deviation [SD] 3.9) VOCs and 1.9 (SD 2.5) hospitalizations per patient per year (PPPY) during follow-up. Patients with TDT had a mean (SD) of 16.4 (11.2) RBCTs and 59.4 (40.8) outpatient visits PPPY.</p><p><strong>Conclusions: </strong>Patients with SCD with recurrent VOCs or TDT in Germany experience significant clinical complications and HCRU.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"291-300"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Mapping the World Health Organization Disability Assessment Schedule (WHODAS 2.0) onto SF-6D Using Swedish General Population Data.","authors":"Anna Philipson, Lars Hagberg, Liselotte Hermansson, Jan Karlsson, Emma Ohlsson-Nevo, Linda Ryen","doi":"10.1007/s41669-024-00549-9","DOIUrl":"10.1007/s41669-024-00549-9","url":null,"abstract":"","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"329"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Clinical to Non-clinical Outcomes in the Treatment of HIV: An Economic and Organizational Impact Assessment.","authors":"Lucrezia Ferrario, Barbara Menzaghi, Giuliano Rizzardini, Alessandro Roccia, Elisabetta Garagiola, Daniele Bellavia, Fabrizio Schettini, Emanuela Foglia","doi":"10.1007/s41669-024-00542-2","DOIUrl":"10.1007/s41669-024-00542-2","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to define the economic and organizational impacts related to a broader utilization of bictegravir/emtricitabine/alafenamide (BIC/FTC/TAF) in Italian clinical practice.</p><p><strong>Methods: </strong>A budget impact analysis-representing the evolution of the Italian National Healthcare Service (NHS) healthcare expenditure over 3 years-was developed, considering the overall Italian population treated for human immunodeficiency virus (HIV). Model input variables were treatment history, therapeutic regimen, development of adverse events, achievement of an undetectable viral load and total direct healthcare costs. Besides the BIA, an organizational impact assessment was conducted to determine the impact on the use of healthcare resources, assessing the release of organizational hospital assets, focusing on the management of drug-related adverse events. Data were collected from scientific evidence, Italian national and regional legislations and healthcare professionals' reports. To verify the robustness of the economic and organizational impact assessment, sensitivity analyses were performed.</p><p><strong>Results: </strong>Results demonstrate economic savings of about 26 million euros in total health spending, assuming a higher penetration rate for BIC/FTC/TAF. This change in the current case mix would lead to a reduction in the specific costs related to adverse event management (0.9 million euros; - 2.09%) and in the medical management of patients (38 million euros; - 7.79%), with a positive impact on the achievement of virological control. From an organizational perspective, a wider use of BIC/FTC/TAF generates a reduction in the utilization of healthcare resources due to a decrease in adverse events and complications. The model estimated a 19.64% reduction in HIV-related inpatient days, which freed up healthcare professional time.</p><p><strong>Conclusions: </strong>Capable of improving both economic and organizational sustainability for the entire HIV care continuum, BIC/FTC/TAF is an efficient therapeutic strategy for people with HIV.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"313-326"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Evaluation of Total Knee Replacement Compared with Non-Surgical Management for Knee Osteoarthritis in India.","authors":"Amatullah Sana Qadeer, Ananda Meher, Jennifer Rachel, Winnie Paulson, Abhilash Patra, Naline Gandhi, Nirupama Ay, Lipika Nanda, Sarit Kumar Rout, Ambarish Dutta","doi":"10.1007/s41669-024-00541-3","DOIUrl":"10.1007/s41669-024-00541-3","url":null,"abstract":"<p><strong>Objective: </strong>This study is an economic evaluation of total knee replacement (TKR) in comparison with non-surgical management in India.</p><p><strong>Methods: </strong>Cost-utility analysis and budget impact analysis (BIA) were conducted on individuals aged ≥ 50 years with osteoarthritis of the knee (OA knee) Kellgren-Lawrence grades 2 and 3 using a provider's perspective. Three scenarios were considered, varying the age at which TKR is administered while assuming a 20-year lifespan for the implant. A Markov model was used to determine incremental cost-effectiveness ratios (ICERs). Sensitivity analysis was conducted incorporating implant costs and other input parameters.</p><p><strong>Results: </strong>Net quality-adjusted life-years (QALYs) gained per OA knee treated with TKR were superior when performed at the age of 50, regardless of OA severity and across all scenarios. The lowest ICER was 36,107 Indian National Rupees (INR) (USD 482.9)/QALY gained, observed at 50 years, while the highest was INR 61,363 (USD 820.72)/QALY gained at 70 years for grade-2 severity. Sensitivity analysis revealed that the ICER was most sensitive to the cost of non-surgical management, health utility values gained in an improved state, and the cost of TKR across scenarios. For the BIA in Scenario 1, with 40% coverage for TKR, costs reach INR 5013 crores (cr) (USD 670,477,060) in 2023 and INR 8444 cr (USD 1,024,628,736) in 2028 (1% of government budgets). In Scenario 2 (full coverage), costs are INR 12,532 cr (USD 1,520,683,008) (2.7%) in 2023, declining to 2.4% in 2028. In Scenario 3, covering 40% under the National Health Mission (NHM), costs vary from 17% in 2023 to 25% in 2028.</p><p><strong>Conclusion: </strong>This study concludes that TKR is a cost-effective treatment option compared with non-surgical management for OA knee in India, irrespective of age, implant types, and severity.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"217-229"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Nivolumab Plus Ipilimumab versus Chemotherapy for Previously Untreated Metastatic NSCLC Using Mixture-Cure Survival Analysis Based on CheckMate 227 5-Year Data.","authors":"Alison D Griffiths, Robert O Young, Yong Yuan, Mohammad A Chaudhary, Adam Lee, Jason Gordon, Philip McEwan","doi":"10.1007/s41669-024-00545-z","DOIUrl":"10.1007/s41669-024-00545-z","url":null,"abstract":"<p><strong>Objectives: </strong>This study assessed the cost-effectiveness of nivolumab plus ipilimumab (NIVO+IPI) versus platinum-doublet chemotherapy (chemo) in untreated metastatic non-small cell lung cancer (NSCLC) using mixture-cure modelling, an approach used to analyse immuno-oncology treatments due to their underlying methods depicting delayed but durable response in some patients.</p><p><strong>Methods: </strong>A mixture-cure economic model was developed from a US third-party payer perspective to assess the lifetime costs and benefits of NIVO+IPI versus chemo using data from Part 1 of the phase III CheckMate 227 trial with 5 years of follow-up. The model consisted of four health states: progression-free without long-term response (non-LTR), progression-free with long-term response (LTR), post-progression, and death. The primary outcomes were the incremental cost per life-year (LY) and quality-adjusted life-year (QALY) gained for NIVO+IPI versus chemo over a patient's lifetime time horizon. Model uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analysis.</p><p><strong>Results: </strong>NIVO+IPI treatment showed a significant improvement in overall survival versus chemo; mean gain 1.69 LYs and 1.42 QALYs. The majority of the 4.04 LYs accrued by NIVO+IPI were in the LTR state (2.27 years). The incremental cost of NIVO+IPI versus chemo was US$125,321, resulting in an incremental cost/QALY gained of US$88,219.</p><p><strong>Conclusions: </strong>This study suggests NIVO+IPI may be a cost-effective first-line treatment when compared with chemo in a US setting given a threshold of US$150,000 per QALY. The cost-effectiveness analysis used a mixture-cure approach, which may offer a more appropriate modelling method in immuno-oncology given LTR, by more accurately capturing the potential treatment benefit.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"247-257"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}