Impact on Health Outcomes and Productive Work of Anti-PD-(L)1 Inhibitors to Treat Early-Stage Cancers in England

Author(s)

Burton H1, Greenall S2, Tan YZ3, Neves C3, Aguiar-Ibáñez R4
1Merck Sharp & Dohme (UK) Ltd, London, LON, UK, 2Lumanity, London, England, UK, 3Lumanity, Utrecht, Netherlands, 4Merck Canada, Inc., Kirkland, QC, Canada

OBJECTIVES: The NHS Long Term Plan states an ambition to improve cancer survival rates and increase the proportion of cases diagnosed at an early stage. Earlier diagnoses will only lead to improved outcomes if patients rapidly receive the appropriate treatment. Anti-PD-(L)1 inhibitors are mainstay treatments for many advanced cancers and their use as adjuvant/perioperative treatment of early-stage tumours has also shown improved outcomes, prompting expansion into these stages. This study estimates the impact on health and productivity outcomes of using anti-PD-(L)1 inhibitors to treat early-stage cancers in England.

METHODS: Four-state Markov models with weekly new cohort entry compared outcomes over 10 years at a population level for two scenarios: (1) without anti-PD-(L)1 inhibitors and (2) with anti-PD-(L)1 inhibitors, for early-stage cancers. The model focused on three early-stage cancers (four indications) with a NICE recommendation for treatment with anti-PD-(L)1 inhibitors (stage III melanoma, stage IIB/C melanoma, triple negative breast cancer, and renal cell carcinoma). Data from clinical trials, national epidemiology statistics, and market share estimates were used to populate the model.

RESULTS: Over 2024−2033, 36,815 (58%) of 62,942 eligible patients in England with the three early-stage cancers (four indications) are estimated to initiate adjuvant/perioperative treatment with anti-PD-(L)1 inhibitors instead of standard chemotherapy or routine monitoring strategies. This is predicted to increase recurrence-free life years by 16,945 (9%) and QALYs by 6,556 (3%), avoid 4,434 (16%) events or recurrences, prevent 3,233 (13%) patients requiring active treatment for metastatic disease, and avoid 2,349 (20%) deaths after recurrence. In addition, it is anticipated to result in 13,837 (17%) productive years gained amongst patients and caregivers.

CONCLUSIONS: Using anti-PD-(L)1 inhibitors as adjuvant/perioperative therapy for early-stage cancers could realise substantial population health benefits and increase economic productivity. Increasing uptake beyond that estimated here would further increase the health and productivity gains that may be achieved.

Conference/Value in Health Info

2024-11, ISPOR Europe 2024, Barcelona, Spain

Value in Health, Volume 27, Issue 12, S2 (December 2024)

Code

CO13

Topic

Clinical Outcomes, Economic Evaluation, Study Approaches

Topic Subcategory

Comparative Effectiveness or Efficacy, Decision Modeling & Simulation, Work & Home Productivity - Indirect Costs

Disease

Drugs, Oncology

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