Evidence map›Paper›PMID 37191852›Full record

ArticleAdvances in therapy2023

Cost-Effectiveness Analysis of Pembrolizumab as an Adjuvant Treatment of Resected Stage IIB or IIC Melanoma in the United States.

Shujing Zhang, Arielle G Bensimon, Ruifeng Xu, Ruixuan Jiang, Alexandra Greatsinger, Adina Zhang, Mizuho Fukunaga-Kalabis, Clemens Krepler

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Advances in therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% of its field
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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Review
  7. Article
  8. Improving assessment of financial toxicity of cancer immunotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
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

8 authors at 2 institutions in 1 country.

Shujing ZhangMerck & Co., Inc., 126 East Lincoln Ave., P.O. Box 2000, Rahway, NJ, 07065, USA. shujing.zhang@merck.com.ORCID 0000-0001-8956-1725
Arielle G BensimonAnalysis Group, Inc., Boston, MA, USA.
Ruifeng XuMerck & Co., Inc., 126 East Lincoln Ave., P.O. Box 2000, Rahway, NJ, 07065, USA.
Ruixuan JiangMerck & Co., Inc., 126 East Lincoln Ave., P.O. Box 2000, Rahway, NJ, 07065, USA.
Alexandra GreatsingerAnalysis Group, Inc., Boston, MA, USA.
Adina ZhangAnalysis Group, Inc., Boston, MA, USA.
Mizuho Fukunaga-KalabisMerck & Co., Inc., 126 East Lincoln Ave., P.O. Box 2000, Rahway, NJ, 07065, USA.
Clemens KreplerMerck & Co., Inc., 126 East Lincoln Ave., P.O. Box 2000, Rahway, NJ, 07065, USA.
Merck & Co., Inc., Rahway, NJ, USA (United States) · USAnalysis Group (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPembrolizumab was approved in the US as adjuvant treatment of patients with stage IIB or IIC melanoma post-complete resection, based on prolonged recurrence-free survival vs. placebo in the Phase 3 KEYNOTE-716 trial. This study aimed to evaluate the cost-effectiveness of pembrolizumab vs. observation as adjuvant treatment of stage IIB or IIC melanoma from a US health sector perspective.

methodsA Markov cohort model was constructed to simulate patient transitions among recurrence-free, locoregional recurrence, distant metastasis, and death. Transition probabilities from recurrence-free and locoregional recurrence were estimated via multistate parametric modeling based on patient-level data from an interim analysis (data cutoff date: 04-Jan-2022). Transition probabilities from distant metastasis were based on KEYNOTE-006 data and network meta-analysis. Costs were estimated in 2022 US dollars. Utilities were based on applying US value set to EQ-5D-5L data collected in trial and literature.

resultsCompared to observation, pembrolizumab increased total costs by $80,423 and provided gains of 1.17 quality-adjusted life years (QALYs) and 1.24 life years (LYs) over lifetime, resulting in incremental cost-effectiveness ratios of $68,736/QALY and $65,059/LY. The higher upfront costs of adjuvant treatment were largely offset by reductions in costs of subsequent treatment, downstream disease management, and terminal care, reflecting the lower risk of recurrence with pembrolizumab. Results were robust in one-way sensitivity and scenario analyses. At a $150,000/QALY threshold, pembrolizumab was cost-effective vs. observation in 73.9% of probabilistic simulations that considered parameter uncertainty.

conclusionAs an adjuvant treatment of stage IIB or IIC melanoma, pembrolizumab was estimated to reduce recurrence, extend patients' life and QALYs, and be cost-effective versus observation at a US willingness-to-pay threshold.

Indexed as

Cost-Effectiveness AnalysisMelanomaAntibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsCost-Benefit AnalysisHumansNeoplasm Recurrence, LocalQuality-Adjusted Life YearsUnited StatesAntibodies, Monoclonal, HumanizedpembrolizumabAdjuvant treatmentCost-effectiveness analysisPembrolizumabStage IIB–IIC melanomaUS health sector perspective

Identifiers

PMID37191852
PMCPMC10271902
OpenAlexW4376641672

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.