OBJECTIVES: The introduction of anti-PD-(L)1s has revolutionized cancer care, offering improved health outcomes in a wide range of tumours. Immunotherapies have been available since 2015 in Greece; however, their expanding use might be considered challenging for healthcare systems' affordability. The Health Impact Projection (HIP) model attempts to estimate the health and economic impact of using anti-PD-(L)1 inhibitors in cancer treatment in Greece.

METHODS: HIP assesses clinical outcomes (life years, progression/recurrence-free survival [PFS/RFS] years, quality-adjusted life-years [QALY] gained) and economic impact (direct & indirect costs), by comparing two scenarios; a world with anti-PD-(L)1s and a world where patients receive standard-of-care (SOC). The model considers a 5-year horizon (2021-2025) and 7 cancer indications: early-stage high-risk melanoma, metastatic melanoma, first-line metastatic non-small-cell lung cancer (1L mNSCLC), locally advanced, unresectable NSCLC, second-line (2L) metastatic urothelial carcinoma after platinum-containing chemotherapy, 1L advanced renal cell carcinoma and 1L/2L metastatic squamous cell head & neck cancer. Model inputs were based on publically available data, literature review and local experts’ input.

RESULTS: HIP estimates that treating 21,067 new cancer patients with anti-PD-(L)1s between 2021-2025 would result in gaining 9,848 life years (+34% vs SoC), 9,632 PFS/RFS years (+70%), and 8,409 QALYs (+40%). Ηealth outcomes continue improving even after the model time horizon, with life years gained showing a growing upwards trend in subsequent years. The associated average economic impact (€202million/year) reaches a plateau by 2025. The additional expenditure of anti-PD-(L)1 medicines represents 1.2% of the total healthcare expenditure (2021). Use of anti-PD-(L)1s could lead to a significant reduction in indirect costs (€260million), helping patients work an additional 9million hours/year.

CONCLUSIONS: Anti-PD-(L)1s’ introduction in cancer care in Greece is associated with significant health benefits for cancer patients in Greece with manageable economic impact. Evidence supports investing in immuno-oncology and ensuring sustainable patient access.