Quotation Pichler, Martin, Steyrer, Johannes. 2021. Cost-effectiveness analysis of the use of immunotherapy in metastatic solid tumours in Austria by applying the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS) version 1.1. ESMO Open. 6 (4), 100198


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Abstract

Background Immune checkpoint inhibitors (ICIs) treatment is a breakthrough in managing metastatic solid tumours, but its use is associated with a high financial burden for public health care systems. Validated tools such as the European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS) are frameworks that might help to better assess the clinical benefit of these novel innovative cancer drugs. Methods Here, we systematically analysed the number of European Medicines Agency-approved ICIs labels with an ESMO-MCBS grade <4 and the impact of the ICIs on incremental costs, gain of life years (LYs), quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio in the Austrian population. Results Of 23 ICIs treatment settings, we identified three clinical scenarios in metastatic solid cancers with an ESMO-MCBS grade <4 with no otherwise approved alternatives. In triple-negative breast cancer (TNBC), the addition of first-line atezolizumab increased QALYs by 0.33 compared with nab-paclitaxel only, with an incremental cost per QALY of €143 853. In small-cell lung cancer (SCLC), the addition of first-line atezolizumab increased the QALY by 0.09, with an incremental cost per QALY of €373 256, and the addition of first-line durvalumab increased the QALYs by 0.11, with an incremental cost per QALY of €589 527. Conclusions Overall, most of the approved ICIs carry significant clinical benefit (≥4). Although TNBC and SCLC are challenging treatment scenarios, currently approved ICIs with an ESMO-MCBS grade <4 substantially increase the cost of medical treatment, and under a willingness-to-pay threshold of €100 000, they do not have a cost-effective comparative benefit.

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Publication's profile

Status of publication Published
Affiliation WU
Type of publication Journal article
Journal ESMO Open
Citation Index SCI
Language English
Title Cost-effectiveness analysis of the use of immunotherapy in metastatic solid tumours in Austria by applying the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS) version 1.1
Volume 6
Number 4
Year 2021
Page from 100198
Reviewed? Y
URL https://api.elsevier.com/content/article/PII:S2059702921001599?httpAccept=text/xml
DOI http://dx.doi.org/10.1016/j.esmoop.2021.100198
Open Access Y
Open Access Link https://www.sciencedirect.com/science/article/pii/S2059702921001599?via%3Dihub

Associations

People
Steyrer, Johannes (Details)
External
Pichler, Martin (Medical University Graz, Austria)
Organization
Interdisciplinary Institute for Management and Organizational Behavior IN (Details)
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