Recent research suggests a particular immunotherapy may be less costly and offer time savings compared with nivolumab for patients with metastatic non-small cell lung cancer (NSCLC).
Immune checkpoint inhibitors, such as atezolizumab (Tecentriq, Genentech/Roche) and nivolumab (Opdivo, Bristol-Myers Squibb), have demonstrated improved survival and tolerability compared with the standard chemotherapy option (docetaxel) for patients with metastatic NSCLC who progress after platinum-containing chemotherapy and regardless of their programmed death-ligand 1 status. However, a cost-comparison has yet to determine which immunotherapy option is less costly and requires fewer hospital visits or less time for infusion.
Researchers from Roche (Basel, Switzerland) and Quintiles IMS (Denver, CO) examined differential costs involved with atezolizumab and nivolumab. A cost framework was developed to calculate costs per course of both immunotherapies, assuming treatment until disease progression or loss of clinical benefit. Additional calculations included administration, infusion time, and management of all-cause grade 3-4 adverse events.
In the base case (mean cycles: 10.34), costs for atezolizumab were less than nivolumab ($90,720 vs $96,028, respectively). Average costs per patient to manage adverse events were $179 for atezolizumab and $572 for nivolumab. Treatment administration costs for atezolizumab were $1410, whereas administration costs were $2114 for nivolumab. Patients average 5.2 fewer hospital visits and 9.84 fewer infusion hours after treatment with atezolizumab. The total difference in costs over a course of care is $5308 per patient, in favor of atezolizumab treatment.
Aside from validating that immunotherapies are valuable treatment options for metastatic NSCLC (with the potential to save $114 million for the US health care system), researchers concluded that atezolizumab may be less costly than nivolumab for treatment of such disease and may offer time savings for patients (fewer office visits, less infusion time). Further investigation is necessary to determine real-world applications and long-term outcomes of immunotherapies.
