5PSQ-013 Economic evaluation of the pembrolizumab dosing regimen by body weight in a second-level private hospital
Bibliographic record
Abstract
Background and Importance Pembrolizumab is a monoclonal antibody directed against the PD-1 surface protein. Initial clinical trials established the 2mg/kg dosage as safe and effective, although later studies supported switching to a fixed dose (200 mg/cycle). The Therapeutic Positioning Report on pembrolizumab indicates that efficacy and safety are comparable and do not present clinically significant variations between the two regimens. Aim and Objectives The objective of this study is to analyse, in real clinical practice, the effectiveness of weight-based dosing of the active ingredient, and the potential opportunity cost compared to fixed dosing. Material and Methods Pharmacoeconomic study of 6.2 months duration (25 September 2023 to 31 March 2024) in a second-level private hospital. All patients who received any regimen with pembrolizumab were included. The variables studied were: sex, age, weight, diagnoses, administered cycles, cost of treatment with pembrolizumab with fixed dose and without weight adjustment. The data were obtained from the electronic medical record and the electronic prescription program Farmis-Oncofarm. Results Twenty-four patients were included (54.17% women) with a median age of 68.83 (IQR, 62.25 to 87.00) years. The average weight was 70.21 kg (SD, 8.91). The most frequent diagnosis was non-squamous non-small-cell lung cancer, accounting for 50.00%, followed by squamous non-small-cell lung cancer and malignant breast neoplasm, both at 8.33%. The average number of chemo-immunotherapy cycles administered per patient was 5.083 (standard deviation). The cost per session at a fixed dose is 7,132.00 euros, while adjusted for weight it is 5,781.63 euros, representing a saving of 18.93%. This translates to a follow-up cost of 939, 639.00 euros (39,151.625 euros per patient), resulting in a gross saving of 183,651.00 euros. This saving is accompanied by the advantage that the effectiveness and safety of the treatment are not affected according to published studies. Conclusion and Relevance Weight-based dosing of pembrolizumab generates a significant opportunity cost without impacting efficacy or safety, making it the most efficient strategy in routine clinical practice. References and/or Acknowledgements Canadian Agency for Drugs and Technologies in Health. CADTH technology review: optimal use 360 report: dosing and timing of immuno-oncology drugs. Published online November 2019. Conflict of Interest No conflict of interest
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".