Objectives: Cemiplimab monotherapy significantly improved overall survival versus chemotherapy in 1L aNSCLC with PD-L1≥50%. Here, we estimate the BI of introducing cemiplimab monotherapy in the US from the healthcare payer’s perspective using updated market share data indicating higher usage of immunotherapy (IO)+chemotherapy and a lower share of IO monotherapy compared to prior analyses in the high PD-L1 population.

Methods: Patients with aNSCLC and PD-L1≥50% without EGFR or ALK mutations were modeled over 3-years. Duration of treatment (DoT) inputs were based on median progression-free survival from published literature. Cemiplimab uptake, projected to increase from 1% (Year 1) to 6% (Year 2) to 10% (Year 3), was displaced from pembrolizumab monotherapy (100%). Other treatments were assumed to remain the same based on market share data over the past 3-years. List price per dose was lower for cemiplimab versus pembrolizumab (ProspectoRx database, November 2021). Adverse event costs were estimated using the 2017 Healthcare Cost and Utilization Project database and event-specific ICD-10 codes, and inflation-adjusted to 2021 costs. Disease management costs were per Centers for Medicare and Medicaid Services data. In univariate sensitivity analyses, inputs were varied by ±20% to model the impact on total 3-year incremental costs.

Results: In a hypothetical 1 milion-member US healthcare plan, ~60 were eligible to receive cemiplimab monotherapy treatment for 1L aNSCLC with PD-L1≥50% in Year 1. The average incremental cost over 3-years was –$0.0029 per-member per-month. The 3-year cumulative incremental BI of introducing cemiplimab monotherapy was –$106,172, representing approximately 0.4% saving in US healthcare payer’s budget. The analysis was most sensitive to changes to DoT; changes to all other inputs had ≤20% impact.

Conclusions: Cemiplimab monotherapy is likely associated with US healthcare payer budgetary savings for treatment of 1L aNSCLC with PD-L1≥50%.