Abstract 1512P
Background
In Ireland, the incidence of cancer was estimated to be 30,272 in 2018, with the incidence expected to rise over the next 5 years by 39% in males and 27% in females. Despite chemotherapy being considered the standard of care (SOC) in many malignancies, it is associated with high levels of toxicity. Immunuotherapy has revolutionized cancer care, offering improved health outcomes. Many treatment options with the potential for use in several cancer types has led to concerns around the long-term affordability of these products. The objective of the study is to estimate and inform discussion around the potential public health and economic impact of PD-1/PD-L1 inhibitors in Ireland.
Methods
The Health Impact Projection (HIP) model estimates the key clinical health and economic outcomes of PD-1/PD-L1 inhibitors in 8 high incidence cancers, over a 5-year period (2020–2024) compared to the SOC. It includes an assessment of the relative health benefits such as life-years gained, and utility-adjusted life years gained and draws on budget impact analysis for its structure and methods. The HIP compares the economic and health outcomes in a world without anti PD-1/PD-L1 treatments versus a world where patients are treated with a mix of SOC and anti PD-1/PD-L1 treatments.
Results
The model shows that over 5 years, the clinical benefits offered by the introduction of anti PD-1/PD-L1s include an additional 3,194 life-years, 2,411 progression-free life years, 2,638 quality-adjusted life years and the avoidance of 92 adverse events. PD-1/PD-L1 inhibitors produce an average annual budget impact that is equivalent to 0.32% of total healthcare expenditure. Amongst this figure is a reduced burden of indirect costs and end of life costs – both of which fall with anti PD-1/PD-L1s on the market.
Conclusions
Ireland faces uncertainty in cancer care with pressure to reduce costs – the HIP helps demonstrate the value of anti PD-1/PD-L1s. Anti PD-1/PD-L1s are predicted to improve outcomes in Ireland with PFS gains being the largest. By projecting budget impact over a five-year period, this model should help inform multi-annual budget planning for innovative oncology medicines. This model informs planning by helping quantify the impact of immuno-oncology treatments on health and budget in different scenarios.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
MSD Ireland.
Disclosure
All authors have declared no conflicts of interest.