Table 1.
Key input data
| Modelling fit and extrapolation approach | Overall survival | PFS | Time-on-treatment |
|---|---|---|---|
| PEM | KEYNOTE-024 KM to 32 weeks, exponential to 5 years, SEER data thereafter | KEYNOTE-024 KM to 9 weeks, Weibull thereafter | Weibull to 2 years (maximum 2 years of treatment assumed) |
| SoC | KEYNOTE-024 KM to 38 weeks, exponential to 5 years, SEER data thereafter | KEYNOTE-024 KM to 9 weeks, exponential thereafter | Generalized gamma (4–6 cycles of platinum, no treatment cap for pemetrexed maintenance) |
| Time-to-death utilities (pooled treatment groups from KEYNOTE-024) | n a | Utilities (95% CI) |
|---|---|---|
| Time to death (days) | ||
| ≥360b | 54 | 0.805 (0.767–0.843) |
| (180, 360) | 26 | 0.726 (0.684–0.767) |
| (30, 180) | 68 | 0.632 (0.592–0.672) |
| <30 | 21 | 0.537 (0.425–0.650) |
| Costs (proportion paid by third-party payersc) | Cost ($US) | Source |
|---|---|---|
| Administration cost for first hour CTX infusion | 224 | CPT: 96413 [23] |
| Administration cost for additional hour CTX infusion | 34 | CPT: 96415 [23] |
| Administration cost per hour for subsequent CTX infusion | 34 | CPT: 96417 [23] |
| PEM weekly cost of disease management in PF | 772 | Estimated from healthcare resource use in KEYNOTE-024 |
| SoC weekly cost of disease management in PF | 1158 | Estimated from healthcare resource use in KEYNOTE-024 |
| Weekly cost of disease management in PD | 1791 | Ramsey et al. [29] |
| PEM post-discontinuation therapy cost | 11,084 | Ramsey et al. [29] |
| SoC post-discontinuation therapy cost | 27,989 | KN024 and Ramsey et al. [29] |
| Cost of terminal care | 31,114 | Chastek et al. [34] |
| Costs and incidence of relevant adverse events (grade 3+) | |||||
|---|---|---|---|---|---|
| Adverse event | Incidence (%) (KEYNOTE-024) | % hospitalizedd | CMS hospitalization cost per event [38] ($US) | Sources (DRG code) [38] | |
| PEM | SoC | ||||
| Anaemia | 4.5 | 23.3 | 50 | 7969.56 | 808; 809; 810 |
| Neutropenia or neutrophil count decreased | 0.0 | 18.0 | 50 | 7969.56 | 808; 809; 810 |
| Pneumonia | 1.9 | 7.3 | 100 | 5963.80 | 193; 194; 195 |
| Thrombocytopenia or platelet count decreased | 0.0 | 12.0 | 30 | 5308.86 | 951 |
| Pneumonitis | 2.6 | 0.7 | 100 | 8766.53 | 177; 178; 179 |
CI confidence interval, CPT current procedural terminology, CTX chemotherapy, DRG diagnosis-related group, KM Kaplan–Meier, PD progressive disease, PD-1 programmed-cell death receptor 1, PEM pembrolizumab, PF progression-free, PFS progression-free survival, SEER Surveillance, Epidemiology and End Results, SoC standard-of-care
aNumber of patients with non-missing EQ-5D index score
bThis time-to-death category includes the records of patients whose death dates were observed or censored ≥360 days after the report of EQ-5D scores. Other categories only include the records of patients with an observed death date
c80% of the total costs were assumed to be covered by healthcare payers
dBased on discussion with clinical experts in an advisory panel meeting