Background: The introduction of immunotherapy has revolutionised cancer care, offering greater survival and health benefits across a range of indications. Population-based outcome assessment for these treatments in Australia has not been undertaken. The objective of the study is to quantify the health impacts of the PD-1/PD-L1 inhibitors to inform public health policy decisions for these treatments in Australia.
Methods: The Health Impact Projection model forecasts the health outcomes of patients receiving PD-1/PD-L1 inhibitors compared to standard of care (SoC) over a 5-year period (2018-2022). A traditional Budget Impact analysis framework was used and augmented to include an assessment of the relative health benefits including Overall Survival, Life Years Gained and Quality of Life. Seven high-incidence cancers were included: melanoma, first and second line NSCLC, urothelial, head and neck, renal cell carcinoma, and triple negative breast cancer. The model was developed in conjunction with international key opinion leaders (medical oncologists, health economists), and the inputs were taken from publicly available data and the literature.
Results: The model predicts that over the 5-year period, an estimated 41,244 patients would receive treatment with one of five PD-1/PD-L1 inhibitors across this range of tumour types. Treatment is predicted to increase overall and progression free survival by 23% and 71% respectively with the adoption of anti PD-1/PD-L1 products over this period. This translates to 16,217 additional life years, and 20,191 years of progression-free survival compared to SOC alone. In addition to this, the superior toxicity profiles associated with the class is expected to result in quality of life improvements, specifically 10,965 predicted grade 3-5 adverse events avoided (35% reduction).
Conclusions: Anti PD-1/PD-L1 treatments are expected to provide sizable improvements in health outcomes, and reduce adverse events experienced by patients. This highlights the importance for the Australian Government of ensuring sustainable access to innovative life-saving treatments.