A new study from Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine examined the cost-effectiveness of durvalumab, a targeted immunotherapy for lung cancer that is known to extend lifespan.
The findings show that the drug exceeded official cost-effectiveness thresholds for all four analyzed countries: the United States, Brazil, Singapore and Spain.
The study could help guide drug-pricing strategies to reduce financial burdens and increase the number of patients who benefit from treatment.
Despite its effectiveness, durvalumab access is limited in some settings. In Brazil, for instance, the drug was approved in 2020 but remains unreimbursed by its public health system.
In this new study, published in the Journal of the American Medical Association Open Access, the researchers developed a model to assess durvalumab’s treatment costs and health benefits in lung cancer patients over a 10-year period.
To calculate treatment costs, the researchers collected a wide range of data, including drug pricing in different countries, administration costs, adverse events and follow-up care. In the U.S., the cost of treatment with durvalumab was $114,394.
To quantify health benefits, the researchers used a measurement commonly used in economic evaluations called quality-adjusted life years (QALYs). This data combines lifespan gains with information on quality of life.
The researchers then generated a single metric called an incremental cost-effectiveness ratio. The researchers found that the cost-effectiveness ratio in the U.S. for durvalumab was $228,788 per QALY.
Though Medicaid and Medicare typically pay for the drug, this cost-effectiveness ratio exceeds the agencies’ threshold target of $150,000. The cost-effectiveness ratios also exceed health system thresholds in the other analyzed countries.
Overall, the study authors concluded that durvalumab treatment for lung cancer remains globally “cost-prohibitive.”
The researchers went on to show how reduced industry pricing can improve cost-effectiveness. This analysis used discounted prices in Singapore that are available through an industry pricing program. The program brought the cost-effectiveness ratio down from $153,461 per QALY to $45,164 — below the official threshold in Singapore.
