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Model-informed approaches to develop drug cost-saving dosing strategies for pembrolizumab
Yan Wang1, Laura H Bukkems1, Johan G C van Hasselt2
1Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, the Netherlands.
European Journal of Cancer (Oxford, England : 1990)
|June 8, 2026
Summary
New subcutaneous pembrolizumab dosing strategies can significantly reduce costs while maintaining therapeutic exposure. Extended intervals and IV administration of the SC formulation offer substantial savings for cancer treatment.
Area of Science:
- Oncology
- Pharmacokinetics
- Health Economics
Background:
- Pembrolizumab is crucial in oncology but incurs high healthcare expenses.
- The subcutaneous (SC) formulation of pembrolizumab is costly.
- Evaluating cost-effective dosing is essential for wider accessibility.
Purpose of the Study:
- To identify alternative subcutaneous pembrolizumab dosing strategies.
- To reduce treatment costs while ensuring equivalent drug exposure.
- To enhance patient convenience in oncological treatments.
Main Methods:
- Utilized a population pharmacokinetic model to assess dosing regimens.
- Evaluated extended fixed and body-weight-adjusted SC dosing intervals.
- Investigated intravenous administration of the SC pembrolizumab formulation.
Main Results:
- Identified SC 790 mg Q7W and body-weight-adjusted SC regimens with cost reductions up to 25%.
- Intravenous administration of the SC formulation showed potential annual savings of 33%.
- Dividing the SC vial for multiple doses could decrease costs by 60%.
Conclusions:
- Extended subcutaneous pembrolizumab dosing intervals maintain exposure and meet regulatory standards.
- Intravenous use of the SC formulation is a cost-effective option requiring safety validation.
- Optimized dosing strategies can improve the economic viability of pembrolizumab therapy.
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