A recent study unveiled intriguing findings about the cost-effectiveness of mesothelioma treatments. Standard chemotherapy is the tried-and-true pemetrexed plus cisplatin combination. But how does it measure up against a newer but pricier alternative, nivolumab plus ipilimumab?
The Gold Standard Treatment
Malignant pleural mesothelioma is an aggressive type of cancer that affects the lining of the lungs. It is caused by exposure to a toxic mineral called asbestos. Conventional treatments for mesothelioma generally consist of chemotherapy, surgery, and sometimes radiation therapy.
The standard chemotherapy treatment for mesothelioma is a combination of two drugs called pemetrexed and cisplatin. This is the only FDA-approved chemotherapy regimen for mesothelioma.
Recently, a new combination of drugs has been found to be even better at shrinking mesothelioma tumors. This new combination is called nivolumab and ipilimumab. But even though it is an effective treatment, it is also expensive.
Balancing Hope and Economics
Scientists looked at data from a big study called CheckMate 743. They used a special computer program to make a model. The model compared the costs and benefits of nivolumab with ipilimumab with the standard chemotherapy drugs. They looked at this over a period of 10 years.
The model showed that nivolumab with ipilimumab was more expensive than the usual chemotherapy. They used a special number called ICER to compare the two drug combinations. For all the patients in the study, the ICER for nivolumab with ipilimumab was $375,656 for each year of good quality life it gave. For patients with the epitheliod type of mesothelioma, it was $327,943. For patients with non-epithelioid types of mesothelioma, it was $115,495.
In simpler terms, this means that using nivolumab with ipilimumab was a lot more expensive than the usual chemotherapy drugs. The cost was much higher than what is usually considered reasonable in healthcare.
In China, where the study focused, it seems that the usual chemotherapy might be a better choice financially. The new treatment combination of nivolumab with ipilimumab was more expensive and didn’t seem to give enough extra benefit to justify the cost.
Yang L, Song X, Zeng W, Zheng Z, Lin W. First-line nivolumab plus ipilimumab for unresectable MPM in China: a cost-effectiveness analysis. Orphanet J Rare Dis. 2023;18(1):326. Published 2023 Oct 16. doi:10.1186/s13023-023-02925-w. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580582/