Nikolaos Themistoklis Yfantopoulos, Panagiota Naoum, Anastasios Skroumpelos, Antonis Karokis, Demet Sönmez, Raquel Aguiar-Ibañez, Vivek Khurana, Anastasios Boutis, Michail Liontos, Zacharenia Saridaki, Kostas Athanasakis
Results indicate that adjuvant/perioperative treatments could provide a significant benefit to patients with cancer, with a manageable additional cost for the healthcare system. The estimations of the model demonstrate a strong call to action for policymakers to enhance access to innovative treatments, since benefits arise for patients, their caregivers, and society as a whole through increased productivity gains.
OBJECTIVES: Cancer incidence and mortality have been increasing both globally and in Greece. The aim of this study was to quantify the health benefits and budget impact of including anti-PD-(L)1's in three early-stage cancer indications, adjuvant melanoma stage IIB/C and III, adjuvant renal cell carcinoma, and perioperative triple-negative breast cancer.
METHODS: A Markov model approach was used to predict clinical outcomes and costs throughout the average patient pathway over a 10-year time horizon. The model includes two scenarios: (1) using anti-PD-(L)1's for patients with early-stage and metastatic disease (ESD scenario) versus (2) treatment with the previous standard of care in the early-stage and anti-PD-(L)1's only in the metastatic disease setting (reference scenario). Estimated outcomes include life-years (LYs), quality-adjusted life-years (QALYs), events or recurrences, productive LYs lost for patients and caregivers, active treatments administered for metastatic disease, deaths, and costs. The model inputs included efficacy data from clinical trials, Greek data on market shares, projected eligible patients, and the respective costs.
RESULTS: Results indicate the following in the ESD scenario: a reduction of 1,722 (25%) recurrences, 881 (24%) deaths, an increase of 5,555 (11%) LYs without recurrence, an increase of productive LYs by 901 (16%) and 2,363 QALYs gained (4%), and a decrease of 1,782 (27%) in active treatments for the metastatic disease setting. The average incremental budget impact per patient per annum was €31,853 throughout the 10-year time horizon of the model from 2023 to 2032.
CONCLUSION: Results indicate that adjuvant/perioperative treatments could provide a significant benefit to patients with cancer, with a manageable additional cost for the healthcare system. The estimations of the model demonstrate a strong call to action for policymakers to enhance access to innovative treatments, since benefits arise for patients, their caregivers, and society as a whole through increased productivity gains.