免疫检查点抑制剂和靶向治疗进展后晚期黑色素瘤患者中 lifileucel 的成本-效用：中等收入经济体背景

This study used a modelling approach that involved the construction and simulation of a partitioned survival model. The target population consisted of patients with treatment-resistant advanced melanoma in Montenegro, a small, middle-income economy.

The study showed that a 1-time therapy with modified lymphocytes derived from the melanoma-infiltrated tissue (lifileucel) is not a cost-effective treatment option for advanced melanoma resistant to targeted and immunotherapy when compared to chemotherapy or triple therapy. The incremental net monetary benefit was -417 270.26 3748.33 EUR and -368 813.66 4220.11 EUR, respectively. The incremental cost-effectiveness ratio was 550 276.80 1 134 093.26 EUR (95% confidence interval) and 675 364.93 1 181 289.48 EUR (95% confidence interval), respectively, which is much above the highest acceptable cost-effectiveness threshold for Montenegro of 86 382.00 EUR per quality-adjusted life year. The sensitivity analysis did not alter this conclusion, which could be clearly confirmed by clinical or prospective cohort studies involving 75-100 patients per arm, requiring an investment of 45-50 million euros.

The treatment of therapy-resistant advanced melanoma using TILs (lifileucel) is currently not cost-effective in small, middle-income economies and is unlikely to become so in the near future.