Authors
Igor Rubinić, Robert Likić, Marina Paladin, Nataša Skočibušić, Ines Mujčin, Ivana Mikolasevic, Vera Vlahović-Palčevski
Published in
Expert review of pharmacoeconomics & outcomes research. Aug 18, 2026. Epub Aug 18, 2026.
Abstract
Pembrolizumab is among the costliest anticancer therapies; fixed dosing may cause drug wastage, particularly in lower-weight patients, adding to health-system budgetary pressure.
This retrospective, single-center pharmacoeconomic analysis compared standard flat-dose pembrolizumab (200 mg every three weeks [Q3W] or 400 mg every six weeks [Q6W]) with a simulated weight-banded strategy (<65 kg, 65-90 kg, ≥90 kg) in adults with advanced non-oncogene-addicted non-small cell lung cancer treated at the Clinical Hospital Centre Rijeka, Croatia, during 2024. Institutional and national public-payer budget impact was modeled using list drug-acquisition prices, with one-way and probabilistic sensitivity analyses.
Ninety-six patients received pembrolizumab during the study period. Weight-banded dosing reduced institutional drug consumption by 25%, yielding annual savings exceeding €1.1 million. National extrapolation, assuming Rijeka accounts for 10-30% of national pembrolizumab use, projected savings of €3.7-11.2 million annually.
Weight-banded pembrolizumab dosing may reduce drug expenditure without evidence of compromised outcomes in this economic model; prospective clinical validation and consideration of pharmacodynamic, safety, and regulatory implications are warranted before implementation.
PMID:
42610975
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.
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