Non-small-cell lung cancer (NSCLC) accounts for approximately 85% of all LC with about 70–75% non-squamous histology and 25–30% squamous histology and is frequently diagnosed as locally advanced or metastatic disease with poor prognosis. In Spain, it was responsible for the highest number of cancer deaths in 2020, causing 22,930 deaths (20.3% of all cancer deaths). Lung cancer (LC) captures the world's attention for it accounts for nearly 20% cancer‐related deaths worldwide. The cost-effectiveness analysis, comparing the two cut-off of IMpower110, shows that atezolizumab provides similar health gains to pembrolizumab but at a lower cost for the first-line treatment of metastasic NSCLC patients in Spain. The sensitivity analyses carried out confirmed the robustness of the base-case results. However, for both cut-offs, atezolizumab produced meaningfully less costs than pembrolizumab (€ − 54,261 with Sept’18 cut-off and € − 81,907 with Feb’20 cut-off). Over a lifetime horizon, the incremental results showed that atezolizumab generated similar health outcomes (LYs and QALYs) to pembrolizumab, with minimal differences depending on the cut-off used (+ 0.70 and + 0.42 LYs and QALYs with Sept’18 cut-off and − 0.80 and − 0.72 LYs and QALYs with Feb’20 cut-off). Both deterministic and probabilistic sensitivity analyses were performed to assess the robustness of results. Health outcomes were expressed as cost per Life Year (LY) and cost per Quality-Adjusted Life Year (QALY). Costs and outcomes were discounted at 3% per year. Direct medical costs were considered based on resources identified by experts. Utility data were collected from the trial. Clinical data for atezolizumab were collected from the interim and the exploratory results (data cut-off: Sept’18 and Feb’20, respectively) of the IMpower110 trial while a network meta-analysis was used to model pembrolizumab treatment. MethodsĪ three-state partitioned-survival model was adapted to Spanish settings to calculate health outcomes and costs over a lifetime horizon. This study aims to estimate the cost-effectiveness of atezolizumab compared with pembrolizumab among these patients in Spanish settings, based on the results of the two cut-offs of the IMpower110 study. Atezolizumab has recently been approved for first-line treatment of high PD-L1 expression metastatic Non-Small-Cell Lung Cancer (NSCLC) patients with no EGFR or ALK mutations, on the basis of the IMpower110 trial.
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