Cost–effectiveness of therapies for melanoma

Abstract

Melanoma presents an important burden worldwide. Until recently, the prognosis for unresectable and metastatic melanoma was poor, with 10% of metastatic melanoma patients surviving for 2 years. The introduction of newer therapies including ipilimumab, vemurafenib, dabrafenib and trametinib improved progression-free survival, with additional benefits anticipated from the forthcoming class of programmed cell death 1 inhibitors. Cost of therapy and resulting cost-effectiveness is an important factor in determining patient access to specific treatments. The objective of this study was to review the published evidence regarding cost-effectiveness of melanoma therapies and provide an overview of the relative cost-effectiveness of available therapies by disease stage. For earlier-stage disease, IFN-α has been found to be cost-effective, although its clinical benefits have not been well established. For unresectable and metastatic melanoma, newer therapies provide benefits over standard-of-care chemotherapy, but comprehensive analyses will need to be conducted to determine the most cost-effective therapy.

Hospitalisation costs of metastatic melanoma in France; the MELISSA study (MELanoma In hoSpital coSts Assessment)

“…Many chemotherapeutic agents have been investigated in the treatment of metastatic melanoma over the last 50 years, but overall response and survival rates have consistently been very low [ 7 ] and no treatment has been demonstrated to be cost-effective at conventional thresholds [ 8 , 9 ]. For this reason, unresectable or metastatic melanoma has remained until very recently an area of high unmet medical need.…”

The efficacy and safety of nivolumab in the treatment of advanced melanoma: a meta-analysis of clinical trials

“…1 Globally, the incidence of melanoma is estimated to be increasing by 3%–7% annually. 2 – 5 However, these figures may represent a substantial underestimate, because many in situ cases and superficial melanomas treated in outpatient settings may go unreported. Many different treatment regimens are available for patients with stage III in-transit metastases.…”

Immuno-therapy in the treatment of cancer: implications for efficacy and economic evaluations

“…L'ingresso sul mercato dei farmaci immunoterapici, sia di quelli già in corso di registrazione che di quelli oggetto di sperimentazione, sta generando grandi aspettative nella comunità scientifica, clinica e nei pazienti, per le importanti evidenze di efficacia. Essendo però il target di tali farmaci più ampio del melanoma metastatico e trattandosi anche di combinazioni di farmaci ad alto costo unitario, queste aspettative sono accompagnate da una diffusa preoccupazione per il relativo impatto economico (4,5).…”