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oncology.jpgNew study reveals notable differences between two leading skin cancer drugs 

Members treated with pembrolizumab had increased adverse events, inpatient utilization, healthcare costs compared to nivolumab. 


Domain(s): Oncology, cost of care

Summary

Background

Pembrolizumab (pembro) and nivolumab (nivo) are drugs used on their own to treat various cancers, like advanced melanoma. Though pembro and nivo are FDA-approved treatments that work with the immune system and are similarly safe and effective, they differ in terms of dosing and frequency of administration. Real-world evidence of treatment patterns, adverse events, and healthcare utilization/cost can be helpful in determining the value of these treatments in different contexts.
 

Methods

Researchers conducted a retrospective observational cohort study that included patients who received at least one fill of pembro or nivo between July 1, 2016, and May 31, 2022. The first fill date was the index date.

Patients needed at least two melanoma diagnosis claims during the study period, with at least one claim after the index date; at least one medical/prescription claim for pembro or nivo on or after diagnosis; and at least two metastasis diagnosis claims 30 days apart post-index date. No checkpoint inhibitor claims were allowed between diagnosis and index dates.

Patients were followed for at least six months following their first infusion to identify treatment patterns, adverse events, and healthcare utilization/costs. Cohorts were then balanced for fair comparison using demographic and disease history data.

Results

  • Among 15 adverse events assessed, pembro patients had higher rates of pneumonitis, colitis, and infusion-related events compared to nivo patients.
  • Post-index all-cause (57% vs 49%) and melanoma-related (44% vs 35%) inpatient utilization was higher for pembro patients than for nivo patients.
  • Average post-index melanoma-specific inpatient costs were higher for pembro patients ($30,741 vs $21,418) compared to nivo patients.

Key Takeaways
  • Health plans can investigate patients at higher risk for pembro-related adverse events and explore any correlation with increased inpatient visits and costs. This insight can help patients choose the most suitable drug for melanoma treatment, potentially reducing adverse reactions and saving on treatment costs.
Fig 1 Oncology.png


Fig 2 Oncology.jpg

Fig 3 Oncology.png


Publications
  • Presented at Academy of Managed Care Pharmacy 2025, 31 March - 3 April, Houston, Texas

Carelon Research project team: Amanda Price (PI), Paige Ball, Amita Ketkar, John Barron 

CarelonRx project team: Stephanie Rusin, Hani Sefain 
 


For more information on a specific study or to connect with the Actionable Insights Committee,
contact us at [email protected].

Sponsor: Carelon Research, Inc., a subsidiary of Elevance Health. This study was funded by CarelonRx.

Dissemination and sharing of the Newsletter is limited to Elevance Health and its subsidiaries, and included findings and implications are for Elevance Health and its affiliates’ internal use only.

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