Cemiplimab for advanced cutaneous squamous cell carcinoma: survival gains at acceptable cost

Abstract

Cemiplimab is a cost-effective treatment option for adults with advanced cutaneous squamous cell carcinoma (CSCC) in the US, according to a study published in Value in Health. The study used a cohort model with a partitioned survival structure to assess the cost effectiveness of cemiplimab, compared with historical standard of care (SOC), for the treatment of CSCC from a US payer perspective over a lifetime horizon.* The model was populated with clinical efficacy and safety data obtained from the cemiplimab phase 2 study. Clinical efficacy data for historical SOC (including platinum-based chemotherapy, cetuximab, erlotinib and gefitinib) were derived from published single-arm clinical trials or retrospective studies. The model showed that cemiplimab resulted in an additional 4.65 discounted life-years (LYs) compared to historical SOC (7.30 vs 2.65) over the full time horizon of the model, reflecting more time spent in both pre-progression (3.17 vs 1.32 LYs) and post-progression (4.14 vs 1.33 LYs) health states compared to historical SOC. Cemiplimab was also associated with an additional 3.74 QALYs versus SOC (5.86 vs 2.12) over the lifetime horizon. Total discounted costs for cemiplimab were higher ($US597 159 vs $225 051). The higher costs for cemiplimab were mainly driven by survival gains for patients treated with cemiplimab that led to higher drug-acquisition and disease-management costs. The incremental cost-effectiveness ratio for cemiplimab was $99 447 per QALY gained, which is below recommended willingness-to-pay thresholds. Cemiplimab offers a cost-effective treatment for patients with advanced CSCC and is expected to provide value for money in the United States from a healthcare payer perspective, conclude the researchers. .