Nivolumab in combination with ipilimumab is a potential cost-effective treatment option for patients with intermediate or poor risk renal cell carcinoma (RCC), according to a study presented at the virtual 2020 ESMO Annual Congress.
The study evaluated survival from randomized controlled trials using standard parametric and alpine distributions to estimate mean lifetime survival and landmark survival. Multiple parametric distributions were tested in scenario analyses.
The cost-effectiveness model used a partitioned survival framework to estimate costs, life-years, and quality-adjusted life years over a 40-year time period. This analysis utilized a US healthcare perspective.
Overall, landmark survival estimates were higher for nivolumab plus ipilimumab and pembrolizumab plus axitinib compared to sunitinib at 5 years (42% and 38% versus 31%, respectively) and 10 years (25% and 19% versus 17%).
Additionally, nivolumab plus ipilimumab was associated with the highest LYs and discounted QALYs of all the treatments. Compared with sunitinib, nivolumab plus ipilimumab was associated with more that twice the LY gain achieved with pembrolizumab and axitinib.
The total discounted incremental costs were lower for nivolumab plus ipilimumab than pembrolizumab plus axitinib compared with sunitinib, including disease management and subsequent therapy costs.
“Nivolumab plus ipilimumab offers aRCC patients with intermediate and poor risk a potential cost-effective treatment option with higher estimated mean long-term survival versus other first-line treatments in the US,” researchers concluded.—Janelle Bradley
Choueiri TK, Stwalley B, Huo S, et al. Comparison of long-term survival and cost-effectiveness (CE) of first-line (1L) treatment options in advanced renal cell carcinoma (aRCC) with intermediate or poor (I/P) prognostic risk. Presented at ESMO Virtual Congress 2020. September 17, 2020. Abstract 717P.
