Descriptive Analysis of Cost-Effectiveness of Novel Immune-Based Cancer Treatments in Türkiye

Background

Within the Target-Specific Pan-Cancer Therapies (PANTER) Project, supported by the TÜBİTAK 1004 Program in Türkiye, several novel immune-based cancer treatment candidates are being developed. Preliminary cost-effectiveness analyses of these therapies have previously been conducted. This study builds on those findings by providing a descriptive interpretation of their cost-effectiveness.

Methods

Cost–utility analyses were conducted from the payer’s perspective using Markov models. Incremental cost–utility ratios (ICURs) were estimated for each treatment. Clinical effectiveness data were derived from publicly available trial results of biologically comparable therapies used as comparators. Health outcomes were expressed as quality-adjusted life years (QALYs), with utility values estimated using proxy measures.

Results

The ICUR for PD-L1 therapy in non-small cell lung cancer (NSCLC) was estimated at €82,497, exceeding the willingness-to-pay threshold of €39,000 for Türkiye. Achieving cost-effectiveness would require either improved utility relative to the comparator (atezolizumab) or a reduction in price. A combined scenario involving a 10% increase in utility and a 30% price reduction (€1,538 per 1200 mg) would be sufficient. For AXL-targeted therapy in hepatocellular carcinoma (HCC), the ICUR was €13,850, indicating cost-effectiveness at equivalent utility and price compared to the comparator (bevacizumab). The ICUR for CAR-T CD19 therapy in B-ALL was €40,911, slightly above the threshold. Cost-effectiveness could be achieved through improved utility relative to the comparator (tisagenlecleucel) or a reduction in price; a 10% price decrease (€271,586 per infusion) would be sufficient.

Conclusions

Novel immune-based cancer treatment candidates developed within the PANTER Project show potential for cost-effectiveness in Türkiye.

Key messages

• AXL-targeted therapy is likely to be cost-effective for hepatocellular carcinoma under current assumptions.

• PD-L1 and CAR-T CD19 therapies may become cost-effective for NSCLC and B-ALL, respectively, if improvements in health outcomes and/or reductions in price are achieved.