Cost–Effectiveness of Pembrolizumab Plus Chemotherapy as First-Line Treatment in PD-L1-Positive Metastatic Triple-Negative Breast Cancer | Zendy

Min Huang | Zendy; Peter A. Fasching | Zendy; Amin Haiderali | Zendy; Wilbur Pan | Zendy; Emma Gray | Zendy; Zheng–Yi Zhou | Zendy; Peter Hu | Zendy; Mitashri Chaudhuri | Zendy; Celine Le Bailly De Tilleghem | Zendy; Nicolas Cappoen | Zendy; Joyce O’Shaughnessy | Zendy

Open Access

Cost–Effectiveness of Pembrolizumab Plus Chemotherapy as First-Line Treatment in PD-L1-Positive Metastatic Triple-Negative Breast Cancer

Author(s) -

Min Huang,

Peter A. Fasching,

Amin Haiderali,

Wilbur Pan,

Emma Gray,

Zheng–Yi Zhou,

Peter Hu,

Mitashri Chaudhuri,

Celine Le Bailly De Tilleghem,

Nicolas Cappoen,

Joyce O’Shaughnessy

Publication year - 2022

Publication title -

immunotherapy

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 1.127

H-Index - 48

eISSN - 1750-7448

pISSN - 1750-743X

DOI - 10.2217/imt-2022-0082

Subject(s) - pembrolizumab , medicine , atezolizumab , oncology , breast cancer , chemotherapy , cost effectiveness , triple negative breast cancer , cancer , immunotherapy , risk analysis (engineering)

Objective: This study evaluated the cost-effectiveness of pembrolizumab/chemotherapy combinations for previously untreated metastatic triple-negative breast cancer patients in the USA with PD-L1 combined positive score ≥10. Methods: A partitioned-survival model was developed to project health outcomes and direct medical costs over a 20-year time horizon. Efficacy and safety data were from randomized clinical trials. Comparative effectiveness of indirect comparators was assessed using network meta-analyses. A series of sensitivity analyses were performed to test the robustness of the results. Results: Pembrolizumab/chemotherapy resulted in total quality-adjusted life-year (QALY) gains of 0.70 years and incremental cost-effectiveness ratio of US$182,732/QALY compared with chemotherapy alone. The incremental cost-effectiveness ratio for pembrolizumab/nab-paclitaxel versus atezolizumab/nab-paclitaxel was US$44,157/QALY. Sensitivity analyses showed the results were robust over plausible values of model inputs. Conclusion: Pembrolizumab/chemotherapy is cost effective compared with chemotherapy as well as atezolizumab/nab-paclitaxel as first-line treatment for PD-L1-positive metastatic triple-negative breast cancer from a US payer perspective.

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