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 |