1555P - Estimating the social value of immuno-oncology (IO) therapies in Japan

Background

Approved for 17 cancers in Japan, use of IO therapy has steadily increased since 2014. For four IO therapies (nivolumab, pembrolizumab, atezolizumab, and durvalumab), we modeled life years saved (LYS), the social value of those LYS, and how that value distributes across manufacturers and society for six, high-burden, advanced/recurrent cancers (non-small cell lung cancer, renal, head and neck squamous cell carcinoma, gastric, urothelial, and endometrial) in Japan.

Methods

A model of IO therapy treatment for six cancers estimated LYS and their monetized value. Per-person survival gains were estimated using digitized overall survival curves relative to a prior treatment standard reported by landmark clinical trials supporting IO therapy approval for each cancer. These per-person gains were scaled to the Japanese population using data from a nationally representative hospital treatment database and monetized to total social value using published estimates of the value of a statistical life year based upon human capital and willingness to pay approaches. Manufacturer and societal shares using time-varying drug and administrative costs were calculated. A 5-year timeframe beginning Jan 1, 2017, comprised our base-case. The impact of analytic timeframe, rates of IO therapy utilization, time on treatment, and treatment efficacy were explored in univariate sensitivity analyses.

Results

The base-case indicated the four IO therapies resulted in 8,851 LYS among patients with the six modeled cancers for a net social value of ¥244B (benefit less treatment costs) of which 86.5% (¥211B) was classified as social surplus (share of value to patients and other parts of society) versus 13.5% (¥33B) to manufacturers (manufacturer share). Estimates were most sensitive to analytic timeframe. Over a 10-year timeframe, an additional 28,715 patients would receive IO therapy for these cancers resulting in 17,863 additional LYS for a ¥509B increase in net social value. While ¥94B additional treatment costs are incurred, the manufacturer share of social value decreased to 4.9%.

Conclusions

In Japan among six high-burden cancers, treatment with four IO therapies has generated substantial social value, and the societal share of that value has increased over time and with increased therapy use.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Merck Sharp & Dohme LLC.

Disclosure

All authors have declared no conflicts of interest.