UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Cost Effectiveness of Avelumab for Metastatic Merkel Cell Carcinoma

Bullement, A; Nathan, P; Willis, A; Amin, A; Lilley, C; Stapelkamp, C; Hatswell, A; ... Bharmal, M; + view all (2019) Cost Effectiveness of Avelumab for Metastatic Merkel Cell Carcinoma. PharmacoEconomics - Open , 3 pp. 377-390. 10.1007/s41669-018-0115-y. Green open access

[img]
Preview
Text
Bullement2019_Article_CostEffectivenessOfAvelumabFor.pdf - Published version

Download (2MB) | Preview

Abstract

BACKGROUND: Metastatic Merkel cell carcinoma (mMCC) is a rare and aggressive skin cancer. Until recently, there were no licensed treatment options for patients with mMCC, and prognosis was poor. A cost-effectiveness analysis was conducted for avelumab, a newly available treatment option for mMCC, versus standard care (SC), from a UK National Health Service perspective. METHODS: A partitioned survival model was developed to assess the lifetime costs and effects of avelumab versus SC. Data from the JAVELIN Merkel 200 trial (NCT02155647) were used to inform estimates of quality-adjusted life-years (QALYs). Unit costs and associated frequencies of use were informed by published literature and clinical expert opinion. Results were presented as incremental cost-effectiveness ratios (ICERs, i.e. the cost per QALY gained) for treatment-experienced (TE) and treatment-naïve (TN) patients. Uncertainty was explored through a range of sensitivity analyses. RESULTS: Discounting costs and QALYs at 3.5% per annum, avelumab was associated with ICERs of £35,274 (TE)/£39,178 (TN) per QALY gained. Probabilistic sensitivity analysis results demonstrated that avelumab was associated with an 88.3% (TE)/69.3% (TN) probability of being cost effective at a willingness-to-pay threshold for end-of-life treatments of £50,000 per QALY gained. Results were most sensitive to alternative survival extrapolations and dosing assumptions. CONCLUSIONS: The analysis results suggest that avelumab is likely to be a cost-effective treatment option for UK mMCC patients. The results for TN patients are subject to some uncertainty, and a confirmatory analysis will be conducted with more mature data.

Type: Article
Title: Cost Effectiveness of Avelumab for Metastatic Merkel Cell Carcinoma
Location: Switzerland
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s41669-018-0115-y
Publisher version: https://doi.org/10.1007/s41669-018-0115-y
Language: English
Additional information: Copyright © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Statistical Science
URI: https://discovery.ucl.ac.uk/id/eprint/10067291
Downloads since deposit
50Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item