Table 1.
Input parameters for all patients.
| Parameter | Baseline value | Range | Distribution | References for baseline value | |
|---|---|---|---|---|---|
| Minimum | Maximum | ||||
| Transitional probabilities | Time-dependent | Estimated from the trial and extrapolated survival curves (6) | |||
| Hazard ratios of N+I+chemotherapy versus chemotherapy a | |||||
| PFS | 0.68 | (7) | |||
| OS | 0.66 | (7) | |||
| Squamous in tumor histology a | 28.0% | Dirichlet (163,419) | (6) | ||
| Grade 3/4 AEs incidence, N+I+chemotherapy a | |||||
| Diarrhea | 4.8% | 3.8% | 5.7% | Beta (17,341) | (6, 7) |
| Rash | 1.7% | 1.3% | 2.0% | Beta (6,352) | (6, 7) |
| Fatigue | 5.5% | 4.4% | 6.6% | Beta (20,338) | (6, 7) |
| Decreased appetite | 1.2% | 0.9% | 1.4% | Beta (4,354) | (6, 7) |
| Nausea | 3.4% | 2.7% | 4.1% | Beta (12,346) | (6, 7) |
| Anemia | 4.8% | 3.8% | 5.7% | Beta (17,341) | (6, 7) |
| Neutropenia | 7.0% | 5.6% | 8.3% | Beta (25,333) | (6, 7) |
| Grade 3/4 AEs incidence, N+I a | |||||
| Diarrhea | 1.7% | 1.4% | 2.0% | Beta (10,566) | (6) |
| Rash | 1.6% | 1.3% | 1.9% | Beta (9,567) | (6) |
| Fatigue | 1.7% | 1.4% | 2.0% | Beta (10,566) | (6) |
| Decreased appetite | 0.7% | 0.6% | 0.8% | Beta (4,572) | (6) |
| Nausea | 0.5% | 0.4% | 0.6% | Beta (3,573) | (6) |
| Anemia | 1.4% | 1.1% | 1.7% | Beta (8,568) | (6) |
| Grade 3/4 AEs incidence, chemotherapy a | |||||
| Diarrhea | 0.7% | 0.6% | 0.8% | Beta (4,566) | (6) |
| Fatigue | 1.4% | 1.1% | 1.7% | Beta (8,562) | (6) |
| Decreased appetite | 1.2% | 1.0% | 1.4% | Beta (7,563) | (6) |
| Nausea | 2.1% | 1.7% | 2.5% | Beta (12,558) | (6) |
| Anemia | 11.6% | 9.3% | 13.9% | Beta (66,504) | (6) |
| Neutropenia | 9.5% | 7.6% | 11.4% | Beta (54,516) | (6) |
| Second-line therapy proportion, N+I+chemotherapy a | |||||
| Chemotherapy | 38.7% | 31.0% | 46.4% | Beta (140,221) | (6, 7) |
| Immunotherapy | 7.1% | 5.7% | 8.5% | Beta (26,335) | (6, 7) |
| Targeted therapy | 6.5% | 5.2% | 7.8% | Beta (23,338) | (6, 7) |
| Second-line therapy proportion, N+I a | |||||
| Chemotherapy | 35.0% | 28.0% | 42.0% | Beta (204,379) | (6) |
| Immunotherapy | 5.5% | 4.4% | 6.6% | Beta (32,551) | (6) |
| Targeted therapy | 5.7% | 4.6% | 6.8% | Beta (33,550) | (6) |
| Second-line therapy proportion, chemotherapy a | |||||
| Chemotherapy | 29.7% | 23.8% | 35.6% | Beta (173,410) | (6) |
| Immunotherapy | 40.8% | 32.6% | 49.0% | Beta (238,345) | (6) |
| Targeted therapy | 5.8% | 4.6% | 7.0% | Beta (34,549) | (6) |
| Health utility | |||||
| N+I with/without chemotherapy | 0.88 | 0.79 | 0.97 | Beta (11.0,1.5) | (30, 31) |
| Chemotherapy | 0.79 | 0.71 | 0.87 | Beta (20.2,5.4) | (30) |
| Progressive disease | 0.72 | 0.65 | 0.79 | Beta (27.3,10.6) | (30) |
| Administration cost ($) b | 149 | 120 | 179 | Gamma (100,1.49) | (23) |
| Drug cost per 6 weeks ($) b | |||||
| Nivolumab plus ipilimumab | 29,890 | 23,912 | 35,868 | Gamma (100,298.90) | (23, 24) |
| Gemcitabine plus carboplatin | 2528 | 2022 | 3034 | Gamma (100,25.28) | (23) |
| Paclitaxel plus carboplatin | 502 | 401 | 602 | Gamma (100,5.02) | (23) |
| Pemetrexed plus carboplatin | 13,791 | 11,033 | 16,550 | Gamma (100,137.91) | (23) |
| Docetaxel | 834 | 667 | 1001 | Gamma (100,8.34) | (26) |
| Nivolumab | 18,756 | 15,005 | 22,507 | Gamma (100,187.56) | (23, 24) |
| Erlotinib | 14,350 | 11,480 | 17,220 | Gamma (100,143.50) | (25) |
| Grade 3/4 AEs cost ($) b | |||||
| Diarrhea | 17,668 | 14,135 | 21,202 | Gamma (100,176.68) | (11, 27) |
| Rash | 16,811 | 13,449 | 20,173 | Gamma (100,168.11) | (11, 27) |
| Fatigue | 17,320 | 13,856 | 20,784 | Gamma (100,173.20) | (11, 27) |
| Decrease appetite | 24,814 | 19,851 | 29,776 | Gamma (100,248.14) | (11, 27) |
| Nausea | 20,698 | 16,558 | 24,837 | Gamma (100,206.98) | (11, 27) |
| Anemia | 21,681 | 17,345 | 26,017 | Gamma (100,216.81) | (11, 27) |
| Neutropenia | 18,386 | 14,709 | 22,063 | Gamma (100,183.86) | (11, 27) |
| BSC cost per 6 weeks ($) b | 4894 | 3915 | 5873 | Gamma (100,48.94) | (28) |
a
Parameter values for patients with PD-L1 ≥ 1% and < 1% and sensitivity analyses based on the CheckMate 9LA trial are shown in Supplementary Table 3 .
b
All costs are expressed in 2020 dollars.
AE, adverse event; BSC, best supportive care; N+I, nivolumab plus ipilimumab; PD-L1, programmed-death ligand 1; PFS, progression-free survival; OS, overall survival.