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Table 3 Results of the scenario sensitivity analyses

From: Cost-effectiveness analysis of pembrolizumab compared to standard of care as first line treatment for patients with advanced melanoma in Hong Kong

 

Comparatora

Pembrolizumab

Pembrolizumab vs. comparator

LYs

QALYs

Costs

LYs

QALYs

Costs

∆ LYs

∆ QALYs

∆ cost

ICER (∆cost/LY)

ICER (∆cost/QALY)

Base case

2.74

1.64

46,079

7.83

4.28

141,131

5.09

2.64

95,052

18,668

35,993

Alternative comparators not reflecting clinical practice

 Pembrolizumab vs. ipilimumab

5.84

3.22

130,793

7.83

4.28

141,131

1.99

1.06

10,338

5196

9761

 Pembrolizumab vs. temozolomide

2.74

1.63

45,409

7.83

4.28

141,131

5.09

2.65

95,722

18,800

36,169

 Pembrolizumab vs. paclitaxel/carboplatin

2.74

1.64

36,551

7.83

4.28

141,131

5.09

2.64

104,580

20,540

39,574

Impact of changing the method of survival (PFS, OS) extrapolation

 PFS modelled based on log-logistic distribution

2.74

1.64

47,593

7.83

4.28

140,423

5.09

2.64

92,830

18,232

35,152

 PFS modelled based on log-normal distribution

2.74

1.64

48,496

7.83

4.28

139,845

5.09

2.64

91,349

17,941

34,591

 OS modelled based on generalised-gamma HR function

2.66

1.60

45,844

7.58

4.15

140,458

4.92

2.56

94,614

19,236

36,967

Varying utility estimates

           

 Progression-based utilities

2.74

1.58

46,079

7.83

4.04

141,131

5.09

2.46

95,052

18,668

38,642

Varying time horizons

           

 5 years

1.62

1.13

40,472

2.85

2.04

120,333

1.23

0.91

79,861

64,912

87,333

 10 years

2.12

1.41

43,652

4.79

3.14

129,090

2.67

1.74

85,438

32,041

49,218

 20 years

2.60

1.60

45,672

7.14

4.10

139,111

4.54

2.50

93,438

20,595

37,367

Varying discount rates

           

 0% for both health benefits and costs

2.74

2.12

52,624

7.83

6.29

166,075

5.09

4.18

113,452

22,282

27,153

 0% for health benefits, 7% for costs

2.74

2.12

44,230

7.83

6.29

134,483

5.09

4.18

90,253

17,726

21,601

 7% for health benefits, 0% for costs

1.99

1.51

52,624

4.72

3.78

166,075

2.73

2.27

113,452

41,482

50,074

 7% for both health benefits and costs

1.99

1.51

44,230

4.72

3.78

134,483

2.73

2.27

90,253

32,999

39,835

Varying practice patterns

           

 Treatment until progression

2.74

1.64

46,079

7.83

4.28

216,013

5.09

2.64

169,934

33,376

64,349

 0% of patients who completed the treatment course received second treatment course

2.74

1.64

46,079

7.83

4.28

132,354

5.09

2.64

86,275

16,945

32,670

 100% of patients who completed the treatment course received second treatment course

2.74

1.64

46,079

7.83

4.28

153,653

5.09

2.64

107,574

21,128

40,735

  1. aDTIC represents the base case comparator reflecting clinical practice unless otherwise specified