Modeling the Ex Post Real Option Value in Metastatic Melanoma Using Real-World Data

Area of Science:

• Health Economics
• Pharmacoeconomics
• Oncology

Background:

• Real option value (ROV) represents the potential benefit from future therapeutic innovations.
• Quantifying ROV in real-world settings is crucial but underexplored.
• Ipilimumab in metastatic melanoma offers a case study for ROV estimation.

Purpose of the Study:

• To estimate the ex post real option value (ROV) of ipilimumab in metastatic melanoma.
• To develop and apply a framework for ROV calculation using real-world data (RWD).
• To assess the impact of subsequent cancer immunotherapy (CIT) availability on ROV.

Main Methods:

• Developed a framework for ROV calculation using RWD.
• Employed a Markov model to estimate quality-adjusted life-years (QALYs) gained.
• Utilized a nationwide electronic health record database to assess survival and CIT uptake.

Main Results:

• Incremental QALYs for ipilimumab vs. chemotherapy were 1.74 without subsequent CIT.
• Subsequent CIT availability increased incremental QALYs by up to 0.92 depending on timing.
• Sensitivity analysis highlighted the importance of ipilimumab survival benefit, CIT survival benefit, and CIT uptake.

Conclusions:

• This is the first study to estimate ex post ROV using RWD.
• Ex post ROV ranged from 1% to 54% of conventional value for patients diagnosed shortly before CIT availability.
• Further research on ROV in other disease areas with longer survival is warranted.