Impact of early-stage immunotherapy on health and work productivity in the Czech Republic, 2024–2033

BACKGROUND: This study evaluated the health and productivity impact of expanding the use of inhibitors of programmed cell death protein 1 (PD-1) or its ligand (PD-L1), referred to as anti-PD-(L)1 agents, to early-stage cancer treatment in the Czech Republic. RESEARCH DESIGN AND METHODS: A four-state Markov-based model compared the use of anti-PD-(L)1 agents for early-stage disease (ESD) treatment of melanoma (stage IIB-C and III), renal cell carcinoma (RCC), and triple-negative breast cancer (TNBC) versus the established use of anti-PD-(L)1 agents only for metastatic disease in the Czech Republic from 2024-2033. Outcomes included recurrence-/event-/disease-free life-years (LYs), total LYs, quality-adjusted LYs (QALYs), productive work years, events/recurrences, metastatic disease treatments, and deaths. RESULTS: Of 16,410 eligible patients, 13,745 initiated ESD treatment with anti-PD-(L)1 agents. ESD treatment was estimated to increase recurrence-/event-/disease-free LYs (+10.6%), QALYs (+4.1%), and productive years for both patients (+22.1%) and caregivers (+21.0%), while decreasing events/recurrences (-22.2%), metastatic treatments (-17.6%), and total deaths (-23.2%). CONCLUSIONS: Expanding the use of anti-PD-(L)1 agents for early-stage cancer treatment in the Czech Republic is expected to reduce events/recurrences and metastatic treatments while also extending survival, quality-of-life, and productive work years, supporting the clinical and societal value of earlier use of innovative immunotherapies.