1752P - Clinical benefit of immunotherapies in advanced cancer in France: A population-based estimate from 2014 to 2021

Background

In France, new treatments’ benefit is evaluated by the Haute Autorité de Santé (HAS) to inform on reimbursement and pricing, but they are rarely evaluated afterwards. Although immunotherapies (ITs) considerably improved patients’ survival, few data are available on their clinical benefit at the population-treated level. The objective of this study was to retrospectively quantify the clinical benefit of ITs compared to previous standard of care (SoC) in France from 2014 to 2021.

Methods

Analysis covers all ITs marketed in early access and/or reimbursed in France between 2014 and 2021, regardless of indication, with a cost-effectiveness (CE) model validated by HAS. For year between 2014 and 2021, the number of patients having initiated an IT, per drug and per indication, was retrieved from the French Hospital Reimbursement database. The clinical benefit was expressed as the number of deaths prevented (DP), life years gained (LYG) and quality-adjusted life years (QALYs) of ITs versus their comparators until 2021. DP and LYG were calculated thanks to extrapolated overall survival curves from randomized clinical trials, validated by the HAS. The number of additional QALYs was calculated using utility scores from the HAS CE opinion. Sensitivity analyses were performed according to the population size, survival, utility values and the period of availability.

Results

From 2014 to 2021, 5 ITs (atezolizumab, avelumab, durvalumab, nivolumab and pembrolizumab) were available in monotherapy or in combination in France corresponding to 8 tumor types and 21 indications. Overall, 132,924 patients initiated an IT, mainly in non-small cell lung cancer (66.5%) and melanoma (12.3%). By Dec 31^st of 2021, 16,173 [13,803 – 17,141] deaths were prevented compared to previous SoC, representing 12.2% of patients initiating an IT. Compared to previous treatments, ITs allowed 37,318 [33,583 – 41,053] LYG and 27,710 [23,785 – 30,451] QALYs. Nivolumab contributed in 64.6% of LYG and 63.1% of QALYs. Early access of ITs participated in 14.7% of DP, 6.1% LYG and 6.0% QALYs.

Conclusions

Immunotherapies allowed significant clinical benefits for French cancer population in term of DP, LYG and QALYs. This type of analysis should be replicate in other countries.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Bristol Myers Squibb.

Funding

Bristol Myers Squibb.

Disclosure

F. Cotté, A. Gaudin, V. Grumberg: Financial Interests, Personal, Full or part-time Employment: BMS. E. Giroux-Leprieur: Financial Interests, Institutional, Research Grant: Bristol Myers Squibb, MSD, Novartis, Roche, Sanofi, Boehringer Ingelheim, AstraZeneca, Takeda, Jansen, Pfizer. C. Lebbe: Financial Interests, Institutional, Advisory Board: Amgen, Bristol Myers Squib, Merck, MSD, Novartis, Pierre Fabre, Roche, Sanofi. All other authors have declared no conflicts of interest.