Clinical and economic analysis of effectiveness of Nivolumab (Opdivo®) use as second-line monotherapy in adult patients with advanced renal cell carcinoma after previous systemic therapy

Abstract

Objecktive. To conduct a comparative pharmacoeconomic analysis of using nivolumab (Opdivo®) as monotherapy in advanced renal cell carcinoma (RCC) in adult patients 2-line therapy. Materials and methods. "Cost-effectiveness" was assessed using a Markov model for one patient with advanced RCC. "Cost-effectiveness" analysis, "cost-utility" analysis "budget impact" analysis were performed. Overall survival and QALYs were included into the model as the effectiveness criteria. All the direct costs were calculated from the Russian healthcare system perspective. Results. Treatment with nivolumab was associated with lower total direct costs, less frequent adverse events compared with the combination lenvatinib + everolimus. Total costs per patient were 2 451 712 rubles and 5 232 592 rubles for nivolumab and the combination lenvatinib + everolimus, respectively. The incremental "cost-effectiveness" ratio was 5 561 760 rubles per life-months gained and 2 339 823 rubles per quality-adjusted life month. A sensitivity analysis confirmed the base case results. "Budget impact" analysis showed that the using of nivolumab allows to save budget costs and to treat additional 198 patients without spending healthcare resources. Conclusion. The results of the study showed that using nivolumab (Opdivo®) as monotherapy in advanced RCC in adult patients as 2-line therapy is clinically effective and "cost-effective" method of treatment of adult patients with RCC in the Russian Federation.