Cost-effectiveness of cetuximab-containing regimens for squamous cell carcinoma of the head and neck in Italy

Aims: To investigate the differences in clinical outcomes and costs for the treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) with a combined positive score (CPS) of 1–19, with pembrolizumab ± chemotherapy or a cetuximab-containing regimen (CCR) in Italy.

Methods: A naïve indirect treatment comparison was conducted, and outcomes were incorporated into a newly developed cost-utility model. Inputs were derived from clinical trials, technology appraisal reports, and published literature. Scenario analyses were undertaken to explore key areas of uncertainty.

Results: Across the comparisons of pembrolizumab ± chemotherapy versus CCRs, incremental life-years ranged from − 0.502 to 0.155, while incremental quality-adjusted life years (QALYs) ranged from − 0.379 to 0.085. In some scenarios, CCRs dominated pembrolizumab ± chemotherapy (i.e. more QALYs at lower costs). In others, CCRs yielded similar estimates of QALYs at lower costs.

Conclusion: CCRs are likely to represent a comparable or more effective treatment option compared to pembrolizumab ± chemotherapy. Model results consistently demonstrated that CCRs are a cost-effective treatment strategy. CCRs remain a relevant treatment option for R/M SCCHN and a CPS of 1–19, for whom a targeted, patient-focused approach is warranted.