A cost-utility analysis of avelumab for metastatic Merkel cell carcinoma in Taiwan

Wen Cheng Chang; Amy Y. Lin; Jason C. Hsu; Chiao En Wu; Connie Goh; Patrick Chou; Kaitlin Kuo; Anne Chang; Roberto Palencia

doi:10.1002/cnr2.1399

A cost-utility analysis of avelumab for metastatic Merkel cell carcinoma in Taiwan

Wen Cheng Chang, Amy Y. Lin, Jason C. Hsu, Chiao En Wu, Connie Goh, Patrick Chou, Kaitlin Kuo, Anne Chang, Roberto Palencia

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Background: Metastatic Merkel cell carcinoma (mMCC) has traditionally been managed with palliative chemotherapy regimens or best supportive care (BSC). Avelumab, a novel anti-programmed death-ligand 1 (PD-L1) human monoclonal antibody for mMCC treatment, is being studied in the pivotal JAVELIN Merkel 200 trial. Aim: Incorporating trial results, this analysis aimed to evaluate the cost-utility of avelumab in Taiwan. Methods and results: A de novo partitioned-survival model with three key health states related to survival (progression-free disease, progressed disease, and death) was applied in this study. The data of clinical efficacy, safety, and patient utilities were obtained from the JAVELIN Merkel 200 trial, literature review, and Taiwanese clinical expert opinion. Cost-utility analysis was performed, and results were presented as cost per quality-adjusted life year (QALY) gained. For treatment-naïve patients, the incremental cost-effectiveness ratios (ICERs) for avelumab vs BSC and avelumab vs chemotherapy were US$44885.06 and US$42993.06 per QALY gained, respectively. As to treatment-experienced mMCC patients, avelumab was associated with ICERs of US$27243.06 (vs BSC)/US$26557.43 (vs chemotherapy) per QALY gained. All ICERs remained consistently within the willingness-to-pay (WTP) threshold of US$53,333.33 per QALY gained. Conclusion: This study demonstrated avelumab to be a cost-effective treatment option for both treatment-experienced and treatment-naïve mMCC patients with very poor prognosis in Taiwan.

Original language	English
Article number	e1399
Journal	Cancer Reports
Volume	4
Issue number	6
DOIs	https://doi.org/10.1002/cnr2.1399
Publication status	Published - Dec 2021

ASJC Scopus subject areas

Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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@article{02b8c53c138a4bf3a97b3954390d2fe4,

title = "A cost-utility analysis of avelumab for metastatic Merkel cell carcinoma in Taiwan",

abstract = "Background: Metastatic Merkel cell carcinoma (mMCC) has traditionally been managed with palliative chemotherapy regimens or best supportive care (BSC). Avelumab, a novel anti-programmed death-ligand 1 (PD-L1) human monoclonal antibody for mMCC treatment, is being studied in the pivotal JAVELIN Merkel 200 trial. Aim: Incorporating trial results, this analysis aimed to evaluate the cost-utility of avelumab in Taiwan. Methods and results: A de novo partitioned-survival model with three key health states related to survival (progression-free disease, progressed disease, and death) was applied in this study. The data of clinical efficacy, safety, and patient utilities were obtained from the JAVELIN Merkel 200 trial, literature review, and Taiwanese clinical expert opinion. Cost-utility analysis was performed, and results were presented as cost per quality-adjusted life year (QALY) gained. For treatment-na{\"i}ve patients, the incremental cost-effectiveness ratios (ICERs) for avelumab vs BSC and avelumab vs chemotherapy were US$44885.06 and US$42993.06 per QALY gained, respectively. As to treatment-experienced mMCC patients, avelumab was associated with ICERs of US$27243.06 (vs BSC)/US$26557.43 (vs chemotherapy) per QALY gained. All ICERs remained consistently within the willingness-to-pay (WTP) threshold of US$53,333.33 per QALY gained. Conclusion: This study demonstrated avelumab to be a cost-effective treatment option for both treatment-experienced and treatment-na{\"i}ve mMCC patients with very poor prognosis in Taiwan.",

author = "Chang, {Wen Cheng} and Lin, {Amy Y.} and Hsu, {Jason C.} and Wu, {Chiao En} and Connie Goh and Patrick Chou and Kaitlin Kuo and Anne Chang and Roberto Palencia",

note = "Funding Information: Medical writing support was provided by FLM Scientific Communication Co., Ltd., Taipei, Taiwan, and funded by Merck Ltd., Taipei, Taiwan, an affiliate of Merck KGaA, Darmstadt, Germany, as part of an alliance between Merck KGaA and Pfizer. Funding Information: This research was financially supported by Merck Ltd., Taipei, Taiwan; an affiliate of Merck KGaA, Darmstadt, Germany, as part of an alliance between Merck KGaA and Pfizer. Amy Y. Lin and Connie Goh are employees of Merck Ltd., Taipei, Taiwan; an affiliate of Merck KGaA, Darmstadt, Germany. Anne Chang was an employee of Merck Ltd., Taipei, Taiwan at the time the analysis was conducted, Roberto Palencia is an employee of Merck KGaA, Darmstadt, Germany. Publisher Copyright: {\textcopyright} 2021 Merck Group. Cancer Reports published by Wiley Periodicals LLC.",

year = "2021",

month = dec,

doi = "10.1002/cnr2.1399",

language = "English",

volume = "4",

journal = "Cancer Reports",

issn = "2573-8348",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "6",

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TY - JOUR

T1 - A cost-utility analysis of avelumab for metastatic Merkel cell carcinoma in Taiwan

AU - Chang, Wen Cheng

AU - Lin, Amy Y.

AU - Hsu, Jason C.

AU - Wu, Chiao En

AU - Goh, Connie

AU - Chou, Patrick

AU - Kuo, Kaitlin

AU - Chang, Anne

AU - Palencia, Roberto

N1 - Funding Information: Medical writing support was provided by FLM Scientific Communication Co., Ltd., Taipei, Taiwan, and funded by Merck Ltd., Taipei, Taiwan, an affiliate of Merck KGaA, Darmstadt, Germany, as part of an alliance between Merck KGaA and Pfizer. Funding Information: This research was financially supported by Merck Ltd., Taipei, Taiwan; an affiliate of Merck KGaA, Darmstadt, Germany, as part of an alliance between Merck KGaA and Pfizer. Amy Y. Lin and Connie Goh are employees of Merck Ltd., Taipei, Taiwan; an affiliate of Merck KGaA, Darmstadt, Germany. Anne Chang was an employee of Merck Ltd., Taipei, Taiwan at the time the analysis was conducted, Roberto Palencia is an employee of Merck KGaA, Darmstadt, Germany. Publisher Copyright: © 2021 Merck Group. Cancer Reports published by Wiley Periodicals LLC.

PY - 2021/12

Y1 - 2021/12

N2 - Background: Metastatic Merkel cell carcinoma (mMCC) has traditionally been managed with palliative chemotherapy regimens or best supportive care (BSC). Avelumab, a novel anti-programmed death-ligand 1 (PD-L1) human monoclonal antibody for mMCC treatment, is being studied in the pivotal JAVELIN Merkel 200 trial. Aim: Incorporating trial results, this analysis aimed to evaluate the cost-utility of avelumab in Taiwan. Methods and results: A de novo partitioned-survival model with three key health states related to survival (progression-free disease, progressed disease, and death) was applied in this study. The data of clinical efficacy, safety, and patient utilities were obtained from the JAVELIN Merkel 200 trial, literature review, and Taiwanese clinical expert opinion. Cost-utility analysis was performed, and results were presented as cost per quality-adjusted life year (QALY) gained. For treatment-naïve patients, the incremental cost-effectiveness ratios (ICERs) for avelumab vs BSC and avelumab vs chemotherapy were US$44885.06 and US$42993.06 per QALY gained, respectively. As to treatment-experienced mMCC patients, avelumab was associated with ICERs of US$27243.06 (vs BSC)/US$26557.43 (vs chemotherapy) per QALY gained. All ICERs remained consistently within the willingness-to-pay (WTP) threshold of US$53,333.33 per QALY gained. Conclusion: This study demonstrated avelumab to be a cost-effective treatment option for both treatment-experienced and treatment-naïve mMCC patients with very poor prognosis in Taiwan.

AB - Background: Metastatic Merkel cell carcinoma (mMCC) has traditionally been managed with palliative chemotherapy regimens or best supportive care (BSC). Avelumab, a novel anti-programmed death-ligand 1 (PD-L1) human monoclonal antibody for mMCC treatment, is being studied in the pivotal JAVELIN Merkel 200 trial. Aim: Incorporating trial results, this analysis aimed to evaluate the cost-utility of avelumab in Taiwan. Methods and results: A de novo partitioned-survival model with three key health states related to survival (progression-free disease, progressed disease, and death) was applied in this study. The data of clinical efficacy, safety, and patient utilities were obtained from the JAVELIN Merkel 200 trial, literature review, and Taiwanese clinical expert opinion. Cost-utility analysis was performed, and results were presented as cost per quality-adjusted life year (QALY) gained. For treatment-naïve patients, the incremental cost-effectiveness ratios (ICERs) for avelumab vs BSC and avelumab vs chemotherapy were US$44885.06 and US$42993.06 per QALY gained, respectively. As to treatment-experienced mMCC patients, avelumab was associated with ICERs of US$27243.06 (vs BSC)/US$26557.43 (vs chemotherapy) per QALY gained. All ICERs remained consistently within the willingness-to-pay (WTP) threshold of US$53,333.33 per QALY gained. Conclusion: This study demonstrated avelumab to be a cost-effective treatment option for both treatment-experienced and treatment-naïve mMCC patients with very poor prognosis in Taiwan.

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A cost-utility analysis of avelumab for metastatic Merkel cell carcinoma in Taiwan

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