Cost of Illness of Stage IV Non-Small Cell Lung Cancer Positive for Programmed Cell Death Ligand 1 (PD-L1) in the US in 2021

Abstract

Specific Aims: To analyze the cost associated with stage IV NSCLC treated with immunotherapy in 2021. Methods: Data extraction from online databases, guideline recommendations, clinical trials and provided market share data. Using progression free survival, overall survival, serious adverse events leading to hospitalization, and death we created a therapy specific cost for one year of treatment. We summed the costs of PD-L1 tests, drugs, hospitalizations, and deaths associated with each treatment arm for a total cost in 2021 US dollars. Results: A total of 22,712 patients were estimated to have stage IV NSCLC treated with PD-L1 immunotherapy in 2021 and were included in this model. Total 2021 costs were estimated at $3.01 billion, with drugs accounting for $2.91 billion of the total. Pembrolizumab had the largest market share of immunotherapy drugs with 97.7%. In each of the sensitivity analyses performed, pembrolizumab was the largest contributor to the total NSCLC cost. Conclusions: Drug cost, specifically pembrolizumab with the largest market share in our model, was the largest driver of total cost. Treatment-related hospitalizations, costs of death and PD-L1 testing, while each in the millions of dollars, contributed little to the total $3.01 billion cost.