Cost-effectiveness of atezolizumab versus pembrolizumab as first-line treatment in PD-L1-positive advanced non-small-cell lung cancer in Spain

Table 2 Model inputs

Model inputs	Base case value	Source
Efficacy parameters^a
PFS	Atezo: Log-logistic distribution Pembro: Relative treatment effect HR-RE model	[17, 22, 33, 34]
OS		[17, 22, 33, 34]
TTD	Atezo: Weibull distribution Pembro: Weibull distribution	[22]
Frequencies of AE grade ≥ 3 with incidence ≥ 2% (Atezo/Pembro)
Hyponatraemia	2.80%/0.00%	[17, 22, 34]
Diarrhoea	0.00%/3.90%
Pneumonitis	5.61%/3.25%
Pyrexia	3.74%/0.00%
Hyperkalaemia^b	1.87% or 3.74%/0.00%
Severe skin reaction	0.93%/5.19%
Utility values (on/off-treatment)
PFS state	0.76	[22]
PPS state	0.69	[22]
Frequency of disease management resources (PFS/PPS state)
Outpatient visit	17/19–20 per year	Expert opinion
GP visit	6/8–9 per year
Hospital nurse visit	4–5/5–6 per year
Primary care nurse visit	6/8–9 per year
Chest CT scan (and others)	4/5 per year
Radiography	1 per year
AEs unit costs (€,2020)
Hyponatraemia	4.831,03 €	GRD_APR (weighted severity level of minor and major.2015)
Diarrhoea	1.108,70 €	[41]
Pneumonitis	3.897,50 €	GRD_AP (Weighted 89, 90.2015)
Pyrexia	830,746 €	[41]
Hyperkalaemia	4.831,03 €	GRD_APR (Weighted severity level of minor and major.2015)
Severe skin reaction	2843,81 €	[41]
Disease management unit costs (€,2020)
Outpatient visit	88,38 €	[37]
GP visit	22,81 €
Hospital nurse visit	26,99 €
Primary care nurse visit	21,15 €
Chest CT scan (and others)	133,56 €
Radiography	36,20 €

Atezo atezolizumab, pembro:pembrolizumab, PFS progression-free survival OS overall survival, TTD time to discontinuation, AE adverse events, GP general practitioner, CT computerised tomography, GRD grupos relacionados con diagnósitco, APR all patient refined, AP all patient
^aAll the extrapolations are fully parametric
^bThe incidence of all AEs with atezolizumab is the same for both cut-offs of IMpower110-study, with the exception of hyperkalaemia, where the incidence is reflected for the Sept’18 and Feb’20 cutoff, respectively

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