Projects per year
Abstract
Background: Economic models in oncology are commonly based on the three-state partitioned survival model (PSM) distinguishing between progression-free and progressive states. However, the heterogeneity of responses observed in immuno-oncology (I-O) suggests that new approaches may be appropriate to reflect disease dynamics meaningfully. Materials and methods: This study explored the impact of incorporating immune-specific health states into economic models of I-O therapy. Two variants of the PSM and a Markov model were populated with data from one clinical trial in metastatic melanoma patients. Short-term modeled outcomes were benchmarked to the clinical trial data and a lifetime model horizon provided estimates of life years and quality adjusted life years (QALYs). Results: The PSM-based models produced short-term outcomes closely matching the trial outcomes. Adding health states generated increased QALYs while providing a more granular representation of outcomes for decision making. The Markov model gave the greatest level of detail on outcomes but gave short-term results which diverged from those of the trial (overstat-ing year 1 progression-free survival by around 60%). Conclusion: Increased sophistication in the representation of disease dynamics in economic models is desirable when attempting to model treatment response in I-O. However, the assumptions underlying different model structures and the availability of data for health state mapping may be important limiting factors.
Original language | English |
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Pages (from-to) | 139-154 |
Number of pages | 16 |
Journal | ClinicoEconomics and Outcomes Research |
Volume | 10 |
DOIs | |
Publication status | Published - 8 Mar 2018 |
Keywords
- Dacarbazine
- Immuno therapy
- Markov
- Metastatic melanoma
- Nivolumab
- Partitioned survival
Projects
- 1 Finished
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Connecting cancer clinical registries with hospital pharmacy dispensing data
Zalcberg, J.
2/01/17 → 2/01/18
Project: Research