The broad societal value of pembrolizumab for women's cancer in Canada.

AIMS: The impact of women's cancers is multifaceted, with broad societal and economic consequences. Health technology assessments often rely solely on costs and outcomes directly relevant to the healthcare system. Our study incorporates the additional and novel value elements across three perspectives for pembrolizumab in four women's cancers in a Canadian setting.

PATIENTS AND

METHODS

We analyzed the net monetary benefit (NMB) of pembrolizumab-based treatments of early-stage triple-negative breast cancer, metastatic triple-negative breast cancer, microsatellite instability-high endometrial cancer, and cervical cancer from three perspectives: traditional payer perspective (TPP), traditional societal perspective (TSP), and broad societal perspective (BSP). Indications and comparators were modeled independently, combined, and weighted by prevalence.

RESULTS

Pembrolizumab-based therapy generated an NMB over four times greater with the BSP (Canadian dollars, CAD$925,078), compared with TPP (CAD$226,090) and TSP (CAD$222,556). The largest driver of results was the inclusion of insurance value. Results excluding insurance value still generated an NMB of CAD$484,384, more than twice the TPP.

CONCLUSIONS

Broadening the perspective to include additional value elements considerably increased the overall value of treatment of women's cancer compared with the TPP, indicating that the perspective used by health technology bodies may not fully capture the societal value of therapeutics.