Authors: Anastasia Ralli

Title: Cost –effectiveness analysis of Nivolumab vs Docetaxel in Advanced Nonsquamous Non Small Cell Lung Cancer”

Abstract

Based on the results of the clinical trial Checkmate 057, Nivolumab has shown improvement in Overall Survival in patients with advanced/metastatic Non squamous NSCLC following treatment with chemotherapy. Although Nivolumab has been approved in Greece, cost effectiveness of Nivolumab compared to Docetaxel for the treatment of Non squamous NSCLC has not been assessed.

Objective. The objective of this analysis is to assess the cost- effectiveness of Nivolumab compared to the conventional care Docetaxel as a second line therapy for treating patients with advanced/metastatic Non squamous NSCLC, in Greece. The viewpoint of the analysis is that of the Greek National Health System.

Method.. Data were derived from the Clinical Trial Checkmate 057, as well as other international and Greek published sources. The clinical effectiveness was measured in life years and QALYs gained and the cost was estimated  combining the volume  of resources used with their unit costs.

Results. Nivolumab compared to Docetaxel was found to have higher cost per patient and to increase overall survival adjusted for quality of life (QALYs). The incremental cost-effectiveness ratio (ICER) was found to be 100.848,77€ per QALY over the lifetime of patients. The results of the sensitivity analysis indicated that the ICER was sensitive to the values of the probabilities of death as well as  time horizon of the analysis.

Conclusion Nivolumab compared to Docetaxel as second line therapy for patients with advanced/metastatic Non squamous NSCLC is not considered a cost-effective option at current prices in the Greek health care setting.