Sequential Targeted Therapy for Advanced, Metastatic, and Recurrent Cervical Cancer: A Cost-Effectiveness Analysis of the Patient Journey

Author:

Richardson Michael T.1ORCID,Attwood Kristopher2,Smith Gabriella3,Liang Su-Ying4,LaVigne Mager Katherine2,Tewari Krishnansu S.5,Coleman Robert L.6,Kapp Daniel S.7,Chan John K.8,Monk Bradley J.9

Affiliation:

1. University of California, Los Angeles, CA, USA

2. Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

3. University of Arizona College of Medicine, Phoenix, AZ, USA

4. Sutter Health, Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA

5. UC Irvine Medical Center, Orange, CA, USA

6. US Oncology Research, The Woodlands, TX, USA

7. Stanford University School of Medicine, Stanford, CA, USA

8. California Pacific Medical Center, Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA

9. Honor Health Research Institute, University of Arizona, Creighton University, Phoenix, AZ, USA

Abstract

Objectives To evaluate outcomes and cost-effectiveness of targeted therapy sequencing for metastatic and recurrent cervical cancer. Method Models were simulated based on phase II and III trials on bevacizumab (bev) from GOG-240, cemiplimab (cemi) from GOG 3016, pembrolizumab (pembro) from KEYNOTE-826, and tisotumab vedotin (tiso) from GOG 3023. Costs were based on IBM Micromedex RED BOOK™ and company listed costs. Results For [chemo + bev → chemo], total cost was $125,918.04, with median overall survival (mOS) of 21.8 months, and cost-effectiveness ratio (CER) of $119,835.79. For [chemo + bev → cemi], total cost was $187,562.99 with mOS of 28.5 months and CER of $162,039.16. For [chemo + bev + pembro → chemo], total cost was $319,963.78 with mOS 32.9 months and CER of $249,930.10. For [chemo + bev + pembro → tiso], total cost was $455,204.45, with mOS 36.5 months and CER of $320,072.99. Conclusion The combination of immunotherapies and biologics have significantly increased overall survival, but with associated higher costs, primarily related to drug costs.

Funder

Denise Cobb Hale and Fisher Family Fund

Publisher

SAGE Publications

Subject

Oncology,Hematology,General Medicine

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