Targeted Therapies Compared to Dacarbazine for Treatment of BRAFv600e Metastatic Melanoma: A Cost-Effectiveness Analysis

摘要

Purpose. Two BRAFv600e targeted therapies, dabrafenib and vemurafenib, have received US approval for treatment of metastatic melanoma in BRAFv600e patients, a mutation that affects -50% of patients. We evaluated the cost-effectiveness of BRAF inhibitors and traditional chemotherapy for treatment of metastatic melanoma. Methods. A Markov model was developed using a societal perspective. Transition probabilities were derived from two Phase III registration trials comparing each BRAF inhibitor against dacarbazine. Costs were obtained from literature, national databases, and Medicare fee schedules. Utilities were obtained from published literature. Deterministic and probabilistic sensitivity analyses were run to test the impact of uncertainties.