Early cost-effectiveness of tumor infiltrating lymphocytes (TIL) for second line treatment in advanced melanoma: a model-based economic evaluation

Retèl, Valesca P.; Steuten, Lotte M. G.; Geukes Foppen, Marnix H.; Mewes, Janne C.; Lindenberg, Melanie A.; Haanen, John B. A. G.; van Harten, Wim H.

doi:10.1186/s12885-018-4788-5

Table 1 Input parameters of base case, including survival probabilities, utilities and costs

From: Early cost-effectiveness of tumor infiltrating lymphocytes (TIL) for second line treatment in advanced melanoma: a model-based economic evaluation

Parameters	Mean	SE	Distribution	Source
Survival probabilities per year
Ipilimumab
PFS	0.175	0.012	Beta	[6]
OS	0.366	0.018	Beta	[6]
TIL
PFS	0.234	0.089^a	Beta	[10, 11]
OS	0.412	0.098^a	Beta	[10, 11]
Utilities and side effects
Ipilimumab
Stable disease	0.850	0.020	Beta	[18]
Progression	0.590	0.020	Beta	[18]
TIL
Stable disease	0.850	0.020	Beta	[18]
Progression	0.590	0.020	Beta	[18]
Utility decrements
Fatigue	0.090	0.020	Beta	[18]
Diarrhea	0.060	0.020	Beta	[18]
Colitis	0.130	0.020	Beta	[18]
Neutropenia	0.130	0.020	Beta	[18]
Dyspnea	0.100	0.020	Beta	[18]
Flu-like syndrome (grade I/II))	0.090	0.020	Beta	[18]
Anaemia	0.110	0.020	Beta	[18]
Likelihood of side effects
Ipilimumab
Fatigue	0.070	0.015	Beta	[6]
Diarrhea	0.060	0.015	Beta	[6]
Colitis	0.060	0.015	Beta	[6]
Dyspnea	0.040	0.015	Beta	[6]
Immune	0.100	0.015	Beta	[6]
Anaemia	0.030	0.015	Beta	[6]
TIL^a
Fatigue	0.001	0.001	Beta	[24]
Diarrhea	0.001	0.001	Beta	[24]
Neutropenia	0.560	0.100	Beta	[24]
Dyspnea	0.020	0.015	Beta	[24]
Immune	0.220	0.100	Beta	[24]
Anaemia	0.440	0.100	Beta	[24]
Failures, non-compliance TIL
Failures	0.100	0.015	Beta	[20], Expert opinion
Non-compliance	0.100	0.015	Beta	[21]
Costs in euros
Costs of ipilimumab total	91,487.50	+/-25%	Gamma
Drug	90,100.00	+/-25%	Gamma	[22]
Administration	473.00	+/-25%	Gamma	[23]
Management of side effects	914.50	+/-25%	Gamma	[6, 16]
Costs of TIL total	62,000.00	+/-25%	Gamma	NKI-AVL
TIL-production-total^b	35,500.00	+/-25%	Gamma	NKI-AVL
Personnel	18,000.00	+/-25%	Gamma	NKI-AVL
Material and quality control	10,000.00	+/-25%	Gamma	NKI-AVL
Cleanroom and equipment	7,500.00	+/-25%	Gamma	NKI-AVL
TIL-hospital-total	26,500.00	+/-25%	Gamma	NKI-AVL
admission	13,000.00	+/-25%	Gamma	NKI-AVL
Preparatory surgery	6,500.00	+/-25%	Gamma	NKI-AVL
Side-effects, medication, monitoring	6,500.00	+/-25%	Gamma	NKI-AVL
Costs of follow-up stable disease^c	516.00	+/-25%	Gamma	[25]
Costs progressive disease^d	9,125.00	+/-25%	Gamma	[31]
Costs of side effects for ipilimumab
Fatigue	198.00	+/-25%	Gamma	[16]
Diarrhea	580.00	+/-25%	Gamma	[16]
Colitis/neutropenia^e	1115.00	+/-25%	Gamma	[16]
Dyspnea	100.00	+/-25%	Gamma	Assumption
Immune	7,680.00	+/-25%	Gamma	[16]
Anaemia	898.00	+/-25%	Gamma	[16]

^aModeled in the first cycle of “stable disease”
^bbased on 10 TIL productions per year
^cbased on 4^a follow-up visit physician+CT scan (stable)
^dcost for palliative care or end-stage disease care was based on the per diem cost of a palliative care unit
^eresembles 2-5 days hospitalization for severe toxicity (grade III-IV)
PFS: Progression Free Survival, OS: Overall Survival; SE: Standard Error; NKI-AVL: Netherlands Cancer Institute-Antoni van Leeuwenhoek hospital
Input cost price calculation NKI-AVL: based on N= 10 patients from the pilot study
Inclusion criteria of the pilot study were: a resectable metastasis of at least 2-3cm; a sufficient heart, lung and kidney function; a maximum of 2 asymptomatic brain metastasis smaller than 1cm; not concurrently being treated with immune function-suppressing medication; not having auto-immune disorders; and a minimum expected life span of 3 months

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ISSN: 1471-2407

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