A cost-effectiveness analysis of nivolumab compared with ipilimumab for the treatment of BRAF wild-type advanced melanoma in Australia
Journal article
Bohensky, Megan A., Pasupathi, Kumar, Gorelik, Alexandra, Kim, Hansoo, Harrison, James P. and Liew, Danny. (2016). A cost-effectiveness analysis of nivolumab compared with ipilimumab for the treatment of BRAF wild-type advanced melanoma in Australia. Value in Health. 19(8), pp. 1009 - 1015. https://doi.org/10.1016/j.jval.2016.05.013
Authors | Bohensky, Megan A., Pasupathi, Kumar, Gorelik, Alexandra, Kim, Hansoo, Harrison, James P. and Liew, Danny |
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Abstract | Purpose The aim of this study was to evaluate the cost-effectiveness of nivolumab versus ipilimumab for the treatment of previously untreated patients with BRAF-advanced melanoma (BRAF-AM) from an Australian health system perspective. Methods A state-transition Markov model was constructed to simulate the progress of Australian patients with BRAF-AM. The model had a 10-year time horizon with outcomes discounted at 5% annually. For the nivolumab group, risks of progression and death were based on those observed in the nivolumab arm of a phase III trial (nivolumab vs. dacarbazine). Progression-free survival and overall survival were extrapolated using parametric survival modeling with a log-logistic distribution. In the absence of head-to-head evidence, overall survival and progression-free survival for ipilimumab were estimated on the basis of an indirect comparison using published data. Costs of managing AM were estimated from a survey of Australian clinicians. The cost of ipilimumab was based on the reimbursement price in Australia. The cost of nivolumab was based on expected reimbursement prices in Australia. Quality-of-life data were obtained within the trial using the EuroQol five-dimensional questionnaire. Results Compared with ipilimumab, nivolumab therapy over 10 years was estimated to yield 1.58 life-years and 1.30 quality-adjusted life-years per person, at a (discounted) net cost of US $39,039 per person. The incremental cost-effectiveness ratios for nivolumab compared with ipilimumab were US $25,101 per year of life saved and $30,475 per quality-adjusted life-year saved. Conclusions Nivolumab is a cost-effective means of preventing downstream mortality and morbidity in patients with AM compared with ipilimumab in the Australian setting. |
Keywords | cost-effectiveness analysis; immunotherapy; melanoma; oncology |
Year | 2016 |
Journal | Value in Health |
Journal citation | 19 (8), pp. 1009 - 1015 |
Publisher | Elsevier |
ISSN | 1098-3015 |
Digital Object Identifier (DOI) | https://doi.org/10.1016/j.jval.2016.05.013 |
Scopus EID | 2-s2.0-84998694454 |
Page range | 1009 - 1015 |
Publisher's version | File Access Level Controlled |
Place of publication | United Kingdom |
https://acuresearchbank.acu.edu.au/item/8824q/a-cost-effectiveness-analysis-of-nivolumab-compared-with-ipilimumab-for-the-treatment-of-braf-wild-type-advanced-melanoma-in-australia
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