Abstract：
UNASSIGNED: Pembrolizumab plus lenvatinib was recently approved for the treatment of advanced or recurrent endometrial carcinoma in women with disease progression on or following prior treatment with a platinum‑containing therapy in any setting, and who are not candidates for curative surgery or radiation (KEYNOTE-775/Study-309; NCT03517449). The objective was to assess the cost effectiveness of pembrolizumab plus lenvatinib compared with chemotherapy from a Swedish healthcare perspective.
UNASSIGNED: A lifetime partitioned-survival model with three health states (progression free, progressed disease, death) was constructed. Chemotherapy was represented by paclitaxel or doxorubicin. Overall survival, progression-free survival, time on treatment, and utility data were obtained from KEYNOTE-775 (database lock: March 1, 2022). Costs (in 2020 Swedish Krona [SEK]) included drug acquisition and administration, health state, end of life, adverse event management, subsequent treatment, and societal (scenario analysis). Outcomes were calculated as quality-adjusted life-years (QALY) and life-years. Model results were presented as incremental cost-effectiveness ratios for all-comers, patients with proficient mismatch repair tumors, and deficient mismatch repair tumors. Deterministic and probabilistic sensitivity analyses were conducted.
UNASSIGNED: Pembrolizumab plus lenvatinib is a cost-effective treatment when compared with chemotherapy, with estimated deterministic and probabilistic incremental cost-effectiveness ratios of SEK 795,712 and 819,757 per QALY gained. Pembrolizumab plus lenvatinib was associated with a large incremental QALY and life-year gain per person versus chemotherapy over the model time horizon (1.49 and 1.76).
UNASSIGNED: Time-to-event data were incomplete and semiparametric and parametric curves were utilized for lifetime extrapolation. Willingness-to-pay thresholds, costs, and utility weights vary by country, which would vary the treatment\'s cost effectiveness in different countries.
UNASSIGNED: This partitioned survival analysis suggests that pembrolizumab plus lenvatinib is cost effective compared with chemotherapy in Sweden for women with advanced or recurrent endometrial carcinoma following previous systemic therapy. Results were robust to mismatch repair status and to changes in parameters/assumptions.
UNASSIGNED: A lifetime partitioned-survival model with three health states (progression free, progressed disease, death) was constructed. Chemotherapy was represented by paclitaxel or doxorubicin. Overall survival, progression-free survival, time on treatment, and utility data were obtained from KEYNOTE-775 (database lock: March 1, 2022). Costs (in 2020 Swedish Krona [SEK]) included drug acquisition and administration, health state, end of life, adverse event management, subsequent treatment, and societal (scenario analysis). Outcomes were calculated as quality-adjusted life-years (QALY) and life-years. Model results were presented as incremental cost-effectiveness ratios for all-comers, patients with proficient mismatch repair tumors, and deficient mismatch repair tumors. Deterministic and probabilistic sensitivity analyses were conducted.
UNASSIGNED: Pembrolizumab plus lenvatinib is a cost-effective treatment when compared with chemotherapy, with estimated deterministic and probabilistic incremental cost-effectiveness ratios of SEK 795,712 and 819,757 per QALY gained. Pembrolizumab plus lenvatinib was associated with a large incremental QALY and life-year gain per person versus chemotherapy over the model time horizon (1.49 and 1.76).
UNASSIGNED: Time-to-event data were incomplete and semiparametric and parametric curves were utilized for lifetime extrapolation. Willingness-to-pay thresholds, costs, and utility weights vary by country, which would vary the treatment\'s cost effectiveness in different countries.
UNASSIGNED: This partitioned survival analysis suggests that pembrolizumab plus lenvatinib is cost effective compared with chemotherapy in Sweden for women with advanced or recurrent endometrial carcinoma following previous systemic therapy. Results were robust to mismatch repair status and to changes in parameters/assumptions.
摘要：
Pembrolizumab联合lenvatinib最近被批准用于治疗晚期或复发性子宫内膜癌，用于在任何情况下使用含铂药物治疗之前或之后出现疾病进展的女性，并且不是治愈性手术或放疗的候选人(KEYNOTE-775/Study-309;NCT03517449)。目的是从瑞典医疗保健的角度评估pembrolizumab联合lenvatinib与化疗相比的成本效益。
■具有三种健康状况的终生分区生存模型（无进展，疾病进展,死亡）被建造。化疗以紫杉醇或阿霉素为代表。总生存率,无进展生存期,治疗时间,和公用事业数据来自KEYNOTE-775（数据库锁定：2022年3月1日）。成本(2020年瑞典克朗[瑞典克朗])包括药物采购和管理，健康状态,生命的终结,不良事件管理，后续治疗,和社会(情景分析)。结果计算为质量调整寿命年(QALY)和寿命年。模型结果表示为所有参与者的增量成本效益比，患有精通错配修复肿瘤的患者，和缺失的错配修复肿瘤。进行确定性和概率敏感性分析。
■与化疗相比，Pembrolizumab联合lenvatinib是一种具有成本效益的治疗方法，每QALY估计的确定性和概率增量成本效益比为795,712瑞典克朗和819,757瑞典克朗。在模型时间范围内，与化疗相比，Pembrolizumab联合lenvatinib与人均QALY和生命年增加相关（1.49和1.76）。
■事件发生时间数据不完整，半参数和参数曲线用于寿命外推。支付意愿门槛，成本,公用事业权重因国家而异，这将改变不同国家的治疗成本效益。
■这项分区生存分析表明，与瑞典的化疗相比，pembrolizumab联合lenvatinib对于先前全身治疗后晚期或复发性子宫内膜癌的女性具有成本效益。结果对于错配修复状态和参数/假设的变化是稳健的。
■具有三种健康状况的终生分区生存模型（无进展，疾病进展,死亡）被建造。化疗以紫杉醇或阿霉素为代表。总生存率,无进展生存期,治疗时间,和公用事业数据来自KEYNOTE-775（数据库锁定：2022年3月1日）。成本(2020年瑞典克朗[瑞典克朗])包括药物采购和管理，健康状态,生命的终结,不良事件管理，后续治疗,和社会(情景分析)。结果计算为质量调整寿命年(QALY)和寿命年。模型结果表示为所有参与者的增量成本效益比，患有精通错配修复肿瘤的患者，和缺失的错配修复肿瘤。进行确定性和概率敏感性分析。
■与化疗相比，Pembrolizumab联合lenvatinib是一种具有成本效益的治疗方法，每QALY估计的确定性和概率增量成本效益比为795,712瑞典克朗和819,757瑞典克朗。在模型时间范围内，与化疗相比，Pembrolizumab联合lenvatinib与人均QALY和生命年增加相关（1.49和1.76）。
■事件发生时间数据不完整，半参数和参数曲线用于寿命外推。支付意愿门槛，成本,公用事业权重因国家而异，这将改变不同国家的治疗成本效益。
■这项分区生存分析表明，与瑞典的化疗相比，pembrolizumab联合lenvatinib对于先前全身治疗后晚期或复发性子宫内膜癌的女性具有成本效益。结果对于错配修复状态和参数/假设的变化是稳健的。
