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Compared with Keytruda, Libtayo resulted in an incremental gain of 3.44 life-years and incremental cost-effectiveness ratio of $130,329 per quality-adjusted life-year.
Libtayo (cemiplimab-rwlc), developed by Regeneron and Sanofi, is a cost-effective treatment for patients with advanced cutaneous squamous cell carcinomas that is not curable by surgery or radiation compared with Merck’s Keytruda (pembrolizumab), according to a recent study published in the Journal of Managed Care + Specialty Pharmacy.
In 2018, the FDA approved Libtayo as the first programmed cell death-1 (PD-1) monoclonal antibody for the treatment of patients with metastatic cutaneous squamous cell carcinomas or locally advanced cutaneous squamous cell carcinomas. The approval was based on combined analysis of data from a phase 2 study and two expansion cohorts.
The FDA approved Keytruda in June 2020 for this indication based on data from the phase 2 KEYNOTE-629 study.
Investigators in this study found that patients treated with Libtayo accrued an additional 2.78 quality-adjusted life-year versus Keytruda over the time horizon of the model, with Libtayo accruing 5.90 QALYs versus Keytruda’s 3.12 QALYs.
At a willingness-to-pay threshold of $150,000/QALY, probabilistic sensitivity analyses indicated a 71% probability that Libtayo is cost-effective when compared with Keytruda. Scenario analysis resulted in incremental cost-effectiveness ratio ranging from $115,909 to $187,374.
Investigators caution, however, that are no head-to-head studies comparing Libtayo and Keytruda in patients with advanced CSCC to inform relative treatment effects in the cost-effectiveness model.
“These results should be interpreted cautiously in the absence of head-to-head trials; however, in the absence of such data, these results can be used to inform health care decisions over resource allocation,” investigators wrote.
Cutaneous squamous cell carcinomas are the second most common skin cancer after basal cell carcinoma, and the incidence is increasing. This cancer accounts for 20% of cutaneous malignancies and about 75% of all deaths due to skin cancer, excluding melanoma.