The economics of cancer immunotherapy: A five-year Medicare B expenditure analysis of checkpoint inhibitors.

Abstract

2569 Background: Immune checkpoint inhibitors (ICIs) have transformed cancer treatment, prompting a comprehensive analysis of Medicare Part B spending trends from 2018 to 2022. Methods: We conducted a detailed examination of Medicare Part B claims data, focusing on spending per dosage unit, total expenditure, and beneficiary utilization across multiple ICI drugs. Results: Our analysis revealed significant variations in ICI utilization and spending, with Keytruda (Pembrolizumab) emerging as the leading drug, totaling 4.94 billion and serving 67,022 beneficiaries in 2022. Notably, Opdivo (Nivolumab) demonstrated substantial market presence with 1.85 billion in spending and 26,957 beneficiaries. Price changes varied considerably, with Pembrolizumab experiencing a 12.9% price increase, Durvalumab rising 8.0%, and Atezolizumab increasing 10.1%. Interestingly, Libtayo showed a modest 1.5% price decrease. Other significant drugs included Tecentriq (Atezolizumab) with 777.8 million in spending and 12,812 beneficiaries, and Imfinzi (Durvalumab) with 562.7 million and 10,517 beneficiaries. Conclusions: Medicare Part B spending on immune checkpoint inhibitors reflects complex market dynamics, characterized by significant variations in drug pricing, beneficiary utilization, and total expenditure, highlighting the evolving landscape of cancer immunotherapy. Cost trajectories and utilization patterns of eight immune checkpoint inhibitors (2018-2022). Brand Name Generic Name Average Spending per Dosage Unit 2022 Annual Growth Rate in Average Spending per Dosage Unit (2018-2022) Total Spending 2022 Total Beneficiaries 2022 Average Spending per Beneficiary 2022 Average Sales Price (ASP) 2022 Bavencio Avelumab $85.86 2.10% $111,862,815 1,591 $70,310 $87.91 Imfinzi Durvalumab $75.86 1.60% $562,741,221 10,517 $53,508 $77.53 Jemperli Dostarlimab-Gxly $216.09 $4,502,157 79 $56,989 $217.87 Keytruda Pembrolizumab $52.18 4.70% $4,935,971,049 67,022 $73,647 $53.42 Libtayo Cemiplimab-Rwlc $27.02 0.10% $203,832,304 3,187 $63,957 $27.45 Opdivo Nivolumab $28.78 4.10% $1,849,938,540 26,957 $68,626 $29.43 Opdualag Nivolumab and relatlimab-rmbw $176.43 $42,513,402 680 $62,520 $180.64 Tecentriq Atezolizumab $79.07 1.50% $777,758,575 12,812 $60,705 $80.79