Background: Immunotherapies have significantly improved survival outcomes in several oncology indications. However, the impact of these treatments on societal outcomes, such as workforce participation, have not been studied. The objective of this study is to examine the effects of PD-1/PD-L1 inhibitors on both health and societal outcomes of populations of patients with cancer in Australia.
Methods: The Health Impact Projection model is a policy-focused model that quantifies the overall health and societal outcomes generated from the time of PD-1/PD-L1 inhibitors introduction to the Australian population, across a number of different therapeutic areas, compared to other widely used treatments over five years. Approved treatments in eight tumour types were considered: melanoma, NSCLC, triple negative breast, urothelial, head and neck, renal cell carcinoma, endometrial and oesophageal cancers.
The structure of the model includes overall survival (OS) and progression free survival (PFS) curves plotted for each of the different cancers over five years. The OS and PFS estimates for available PD1/PDL1 treatments were used for each cancer type based on estimated utilization of each type of treatment. From these two curves, the proportion of patients who are pre-progression, post-progression and deceased can be calculated to estimate both health and societal outcomes.
Results: Relative to the base case scenario, the analysis showed that between 2021-2025, treatment of 60,982 patients with immunotherapy across the approved indications in eight tumour types resulted in an increase of 25,176 life years and 20,827 progression-free years. The model suggested that treatment with immunotherapy also resulted in patients being able to work an additional 20,038,202 hours and contribute $22,822,580 additional tax dollars.
Conclusions: Treatment with immunotherapy has potential impact on both health and societal outcomes for Australian patients with cancer. This research highlights the importance of working with policy makers to acknowledge the societal benefits when funding new medicines.