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Cost Estimate of Immune-Related Adverse Reactions Associated with Innovative Treatments of Metastatic Melanoma

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Abstract

Background and Objective

Immuno-oncology therapies represent a new treatment opportunity for patients affected by metastatic melanoma. The purpose of this study was to estimate the costs of immune-related adverse events (irAEs) associated with the new anti-PD1 immuno-oncology therapies, with the anti-CTLA-4 immuno-oncology therapy and with the combined therapy (CTLA4 + anti-PD1) in patients affected by metastatic melanoma.

Materials and Methods

A probabilistic cost-of-illness (COI) model was developed to estimate the management costs of grade ≥ 3 adverse events associated with the new anti-PD1 therapies (pembrolizumab and nivolumab), the anti-CTLA-4 therapy (ipilimumab) and the combined therapy CTLA4 + anti-PD1 (nivolumab + ipilimumab) for the treatment of patients with metastatic melanoma from the National Health Service (NHS) perspective in Italy. Identification of the epidemiological and cost parameters was carried out through a systematic literature review (SLR). Univariate and probabilistic sensitivity analyses were performed to account for uncertainty and variation in the model results.

Results

The model estimated a cost associated with the management of grade ≥ 3 immune-related adverse events in patients with metastatic melanoma equal to €176.2 (95% CI 63.5–335.0) for anti-CTLA-4 therapy, €48.6 (95% CI 40.1–58.5) for the new anti-PDI therapies and €276.8 (95% CI 240.4–316.2) for the combined therapy. Among the innovative therapies for the considered metastatic melanoma, the combined therapy was the most expensive innovative treatment in terms of event management of immune-related grade ≥ 3 adverse events.

Conclusion

This study may represent a useful tool to understand the economic burden associated with the management of irAEs associated with patients affected by metastatic melanoma.

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Authors and Affiliations

  1. Economic Evaluation and HTA (CEIS-EEHTA), Faculty of Economics, University of Rome “Tor Vergata”, Via Columbia 2, 00133, Rome, Italy

    Francesco S. Mennini, Chiara Bini & Andrea Marcellusi

  2. Institute for Leadership and Management in Health, Kingston University London, Kingston Hill, Kingston upon Thames, London, KT2 7LB, UK

    Francesco S. Mennini & Andrea Marcellusi

  3. Unit of Medical Oncology 2, Department of Medical Oncology, IRCCS Foundation-National Cancer Institute, Milan, Italy

    Michele Del Vecchio

Authors
  1. Francesco S. Mennini
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  2. Chiara Bini
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  3. Andrea Marcellusi
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  4. Michele Del Vecchio
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Corresponding author

Correspondence to Chiara Bini.

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Conflict of interest

The authors declare no conflict of interest.

Funding

This work was supported by an unrestricted grant from MSD Italia.

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Cite this article

Mennini, F.S., Bini, C., Marcellusi, A. et al. Cost Estimate of Immune-Related Adverse Reactions Associated with Innovative Treatments of Metastatic Melanoma. Clin Drug Investig 38, 967–976 (2018). https://doi.org/10.1007/s40261-018-0690-9

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  • DOI: https://doi.org/10.1007/s40261-018-0690-9

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