Evidence map›Paper›PMID 29524005›Full record

Trial reportThe European journal of health economics : HEPAC : health economics in prevention and care2018

The cost-effectiveness of nivolumab monotherapy for the treatment of advanced melanoma patients in England.

Yang Meng, Nadine Hertel, John Ellis, Edith Morais, Helen Johnson, Zoe Philips, Neil Roskell, Andrew Walker, Dawn Lee

Abstract readClinical Trial, Phase IIIRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The European journal of health economics : HEPAC : health economics in prevention and care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Cost-Effectiveness of Current Therapeutic Strategies for Melanoma.Current treatment options in oncology · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yang MengBresMed Health Solutions, North Church House, 84 Queen Street, Sheffield, S1 2DW, UK. ymeng@bresmed.com.ORCID http://orcid.org/0000-0003-1866-537X
Nadine HertelBristol-Myers Squibb Pharmaceuticals, Uxbridge, UK.
John EllisBristol-Myers Squibb Pharmaceuticals, Uxbridge, UK.
Edith MoraisBristol-Myers Squibb Pharmaceuticals, Uxbridge, UK.
Helen JohnsonHelen Johnson Consulting Ltd, Welwyn Garden City, UK.
Zoe PhilipsBresMed Health Solutions, North Church House, 84 Queen Street, Sheffield, S1 2DW, UK.
Neil RoskellBresMed Health Solutions, North Church House, 84 Queen Street, Sheffield, S1 2DW, UK.
Andrew WalkerUniversity of Glasgow, Glasgow, UK.
Dawn LeeBresMed Health Solutions, North Church House, 84 Queen Street, Sheffield, S1 2DW, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNivolumab was the first programmed death receptor 1 (PD-1) immune checkpoint inhibitor to demonstrate long-term survival benefit in a clinical trial setting for advanced melanoma patients.

objectiveTo evaluate the cost effectiveness of nivolumab monotherapy for the treatment of advanced melanoma patients in England.

methodsA Markov state-transition model was developed to estimate the lifetime costs and benefits of nivolumab versus ipilimumab and dacarbazine for BRAF mutation-negative patients and versus ipilimumab, dabrafenib, and vemurafenib for BRAF mutation-positive patients. Covariate-adjusted parametric curves for time to progression, pre-progression survival, and post-progression survival were fitted based on patient-level data from two trials and long-term ipilimumab survival data. Indirect treatment comparisons between nivolumab, ipilimumab, and dacarbazine were informed by these covariate-adjusted parametric curves, controlling for differences in patient characteristics. Kaplan-Meier data from the literature were digitised and used to fit progression-free and overall survival curves for dabrafenib and vemurafenib. Patient utilities and resource use data were based on trial data or the literature. Patients are assumed to receive nivolumab until there is no further clinical benefit, assumed to be the first of progressive disease, unacceptable toxicity, or 2 years of treatment.

resultsNivolumab is the most cost-effective treatment option in BRAF mutation-negative and mutation-positive patients, with incremental cost-effectiveness ratios of £24,483 and £17,362 per quality-adjusted life year, respectively. The model results are most sensitive to assumptions regarding treatment duration for nivolumab and the parameters of the fitted parametric survival curves.

conclusionsNivolumab is a cost-effective treatment for advanced melanoma patients in England.

Indexed as

AgedAge FactorsAntineoplastic Agents, ImmunologicalAntineoplastic Combined Chemotherapy ProtocolsCost-Benefit AnalysisDacarbazineDisease-Free SurvivalDisease ProgressionFemaleHealth ExpendituresHealth ResourcesHumansImidazolesIpilimumabKaplan-Meier EstimateMaleAntineoplastic Agents, ImmunologicalBRAF protein, humandabrafenibDacarbazineImidazolesIpilimumabNivolumabOximesProto-Oncogene Proteins B-rafVemurafenibAdvanced melanomaCost-effectivenessEconomic evaluationNivolumab

Identifiers

PMID29524005

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.