Table 4.
Treatment-related grade 3/4 AE costs associated nivolumab plus ipilimumab, nivolumab plus cabozantinib, and pembrolizumab plus lenvatinib (median follow-up of ~26.6 months).a
| AE | Unit costb | NIVO + IPI (N = 547) |
NIVO + CABO (N = 320) |
PEM + LEN (N = 352) |
|---|---|---|---|---|
| Asthenia | $13 679 | — | — | $622 |
| Decreased appetite | $9260 | — | $116 | $316 |
| Diarrhea | $7736 | $297 | $508 | $637 |
| Dysgeusia | $7471 | — | $0 | — |
| Dysphonia | $6819 | — | — | $0 |
| Fatigue | $7979 | $335 | $199 | $249 |
| Hypertension | $7023 | — | $812 | $1756 |
| Hypothyroidism | $9673 | — | $30 | $110 |
| Increased ALT | $8504 | — | $425 | — |
| Increased AST | $8504 | — | $292 | — |
| Mucosal inflammation | $15 868 | — | $149 | — |
| Nausea | $7547 | $110 | $24 | $129 |
| PPE syndrome | $6480 | — | $486 | $258 |
| Proteinuria | $7860 | — | — | $581 |
| Pruritus | $4690 | $26 | — | — |
| Rash | $6480 | $95 | $121 | $221 |
| Stomatitis | $8930 | — | — | $152 |
| Total costc | $863 | $3162 | $5030 |
Notes: [a] “—” represents an AE that was not experienced in any grade by ≥ 20% of patients treated with nivolumab plus ipilimumab in the CheckMate 214 trial, nivolumab plus cabozantinib in the CheckMate 9ER trial or pembrolizumab plus lenvatinib in the KEYNOTE-426 trial, or not reported among patients treated with pembrolizumab plus axitinib in the KEYNOTE-581 trial, Motzer et al. [b] AE unit costs were based on AE-related hospitalization cost, which were estimated from the Healthcare Cost and Utilization Project (HCUP) 2017 National Inpatient Database based on the ICD-10 diagnosis codes associated with each AE. Cost inputs were inflated from 2017 USD to 2020 USD using an inflation factor of 1.0793 based on the Consumer Price Index (CPI) for all urban consumers in medical care service. [c] Total costs were calculated by multiplying each AE rate by the corresponding AE unit cost and reflect the rounded sum of the individual AE costs in each treatment arm.
Abbreviations: AE, adverse event; NIVO + CABO, nivolumab plus cabozantinib; NIVO + IPI, nivolumab plus ipilimumab; PEM + LEN, pembrolizumab plus lenvatinib; PPE, palmar-plantar erythrodysesthesia.