A recent budget analysis evaluated the costs, safety, and efficacy of personalized dosing compared with fixed dosing of standard-of-care treatment for non-small cell lung cancer, presented at the 2017 ASCO Annual Meeting (June 2-6, 2017; Chicago, IL).
Pembrolizumab has been considered the standard of care for first-line treatment of patients with metastatic non-small cell lung cancer (mNSCLC) since 2016. The US Food and Drug Administration (FDA) has since recommended a fixed dose of 200 mg pembrolizumab every 3 weeks for mNSCLC patients. However, the costs, safety, and efficacy of fixed dosing compared with personalized dosing for pembrolizumab have yet to be considered.
Daniel A Goldstein, MD, and colleagues from various multinational health centers compared fixed dosing with personalized dosing and calculated the target population who would receive pembrolizumab annually in the first-line setting from a United States societal perspective. Researchers also estimated the mean number of cycles that patients would receive via survival curves from the KEYNOTE 024 trial with Weibull extrapolation. Additionally, the researchers calculated the cost difference between personalized and fixed dosing using the Medicare average sales price.
The results indicated that the total annual cost of pembrolizumab with fixed dosing is nearly $3.5 billion, whereas the cost with personalized dosing is about $2.6 billion. The researchers noted that personalized dosing would likely save more than $825 million (24%) annually in the United States.
Therefore, researchers concluded that personalized dosing of pembrolizumab is cheaper and equally effective as fixed dosing in treating mNSCLC.
“Personalized dosing of pembrolizumab may have the potential to save approximately $0.825 billion annually in the United States, likely without impacting outcomes,” researchers explained. “This option should be considered for the first-line management of PD-L1-positive advanced lung cancer.”—Christina Vogt