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Economic evaluation of nivolumab as a second‐line treatment for advanced renal cell carcinoma from US and C hinese perspectives
Author(s) -
Wan Xiao Min,
Peng Liu Bao,
Ma Jin An,
Li Yuan Jian
Publication year - 2017
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.30666
Subject(s) - nivolumab , medicine , renal cell carcinoma , willingness to pay , cost effectiveness , cost–benefit analysis , quality adjusted life year , oncology , immunotherapy , cancer , economics , risk analysis (engineering) , ecology , biology , microeconomics
BACKGROUND Nivolumab is a new standard of care for patients with metastatic renal cell carcinoma (mRCC) and provides an overall survival benefit of 5.40 months in comparison with everolimus. This study evaluated the cost‐effectiveness of nivolumab for the second‐line treatment of mRCC from the perspective of US payers and identified the range of drug costs for which the addition of nivolumab to standard therapy could be considered cost‐effective from a Chinese perspective. METHODS A partitioned survival model was constructed to estimate lifetime costs, life‐years, and quality‐adjusted life‐years (QALYs). Costs were estimated for the US and Chinese health care systems. One‐way and probabilistic sensitivity analyses were performed. RESULTS Nivolumab provided an additional 0.29 QALYs at a cost of $151,676/QALY in the United States. The probabilistic sensitivity analysis showed that at a willingness‐to‐pay threshold of $100,000/QALY, at the current cost of nivolumab, the chance of nivolumab being cost‐effective was 3.10%. For China, when nivolumab cost less than $7.90 or $9.70/mg, there was a nearly 90% likelihood that the incremental cost‐effectiveness ratio for nivolumab would be less than $22,785 or $48,838/QALY, respectively. CONCLUSIONS For the United States, nivolumab is unlikely to be a high‐value treatment for mRCC at the current price, and a price reduction appears to be justified. In China, value‐based prices for nivolumab are $7.90 and $9.70/mg for the country and Beijing City, respectively. This study could and should inform the multilateral drug‐price negotiations in China that may be upcoming for nivolumab. Cancer 2017;123:2634‐41 . © 2017 American Cancer Society .