{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:04:11Z","timestamp":1773705851722,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,2]],"date-time":"2021-05-02T00:00:00Z","timestamp":1619913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009945","name":"Merck KGaA","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009945","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Metastatic Merkel cell carcinoma (mMCC) has traditionally been managed with palliative chemotherapy regimens or best supportive care (BSC). Avelumab, a novel anti\u2010programmed death\u2010ligand 1 (PD\u2010L1) human monoclonal antibody for mMCC treatment, is being studied in the pivotal JAVELIN Merkel 200 trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>Incorporating trial results, this analysis aimed to evaluate the cost\u2010utility of avelumab in Taiwan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>A de novo partitioned\u2010survival model with three key health states related to survival (progression\u2010free disease, progressed disease, and death) was applied in this study. The data of clinical efficacy, safety, and patient utilities were obtained from the JAVELIN Merkel 200 trial, literature review, and Taiwanese clinical expert opinion. Cost\u2010utility analysis was performed, and results were presented as cost per quality\u2010adjusted life year (QALY) gained. For treatment\u2010na\u00efve patients, the incremental cost\u2010effectiveness ratios (ICERs) for avelumab vs BSC and avelumab vs chemotherapy were US$44885.06 and US$42993.06 per QALY gained, respectively. As to treatment\u2010experienced mMCC patients, avelumab was associated with ICERs of US$27243.06 (vs BSC)\/US$26557.43 (vs chemotherapy) per QALY gained. All ICERs remained consistently within the willingness\u2010to\u2010pay (WTP) threshold of US$53,333.33 per QALY gained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrated avelumab to be a cost\u2010effective treatment option for both treatment\u2010experienced and treatment\u2010na\u00efve mMCC patients with very poor prognosis in Taiwan.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1399","type":"journal-article","created":{"date-parts":[[2021,5,2]],"date-time":"2021-05-02T07:56:22Z","timestamp":1619942182000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A cost\u2010utility analysis of avelumab for metastatic Merkel cell carcinoma in Taiwan"],"prefix":"10.1002","volume":"4","author":[{"given":"Wen\u2010Cheng","family":"Chang","sequence":"first","affiliation":[{"name":"Division of Haematology\u2010Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou Chang Gung University College of Medicine  Taoyuan Taiwan"},{"name":"College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4917-0222","authenticated-orcid":false,"given":"Amy Y.","family":"Lin","sequence":"additional","affiliation":[{"name":"Merck Ltd.  Taipei Taiwan"},{"name":"Merck KGaA  Darmstadt Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason C.","family":"Hsu","sequence":"additional","affiliation":[{"name":"International Ph.D. Program in Biotech and Healthcare Management, College of Management Taipei Medical University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiao\u2010En","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Haematology\u2010Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou Chang Gung University College of Medicine  Taoyuan Taiwan"},{"name":"College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Connie","family":"Goh","sequence":"additional","affiliation":[{"name":"Merck Ltd.  Taipei Taiwan"},{"name":"Merck KGaA  Darmstadt Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Chou","sequence":"additional","affiliation":[{"name":"IQVIA Solutions Taiwan Ltd.  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaitlin","family":"Kuo","sequence":"additional","affiliation":[{"name":"IQVIA Solutions Taiwan Ltd.  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Chang","sequence":"additional","affiliation":[{"name":"Merck Ltd.  Taipei Taiwan"},{"name":"Merck KGaA  Darmstadt Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Palencia","sequence":"additional","affiliation":[{"name":"Merck KGaA  Darmstadt Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1972.01620040075020"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.10.022"},{"issue":"6","key":"e_1_2_11_4_1","first-page":"459","article-title":"Evaluation of treatment and prognosis of Merkel cell carcinoma of the eyelid in Japan","volume":"111","author":"Matsushita E","year":"2007","journal-title":"Nippon Ganka Gakkai Zasshi"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2010.01.020"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2011.05251.x"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000017538"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4713"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bj.2017.08.002"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.19218"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2217\/fon-2017-0187"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30364-3"},{"key":"e_1_2_11_13_1","unstructured":"D'AngeloSP Lebb\u00e9C MortierL BrohlA FazioN GrobJJ et al.First\u2010line avelumab treatment in patients with metastatic Merkel cell carcinoma: primary analysis after \u226515 months of follow\u2010up from JAVELIN Merkel 200 a registrational phase 2 trial.SITC 2019 Congress. 2019; Nov 6\u201310."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2020-000674"},{"key":"e_1_2_11_15_1","unstructured":"Taiwan Food and Drug Administration Ministry of Health and Welfare.License Detail [Internet].2018https:\/\/info.fda.gov.tw\/mlms\/H0001D.aspx?Type=Lic&LicId=60001085"},{"key":"e_1_2_11_16_1","unstructured":"U.S. Food & Drug Administration.Resources for Information | Approved Drugs [Internet]. 2017.https:\/\/www.fda.gov\/drugs\/resources-information-approved-drugs\/avelumab-bavencio"},{"key":"e_1_2_11_17_1","unstructured":"European Medicines Agency Science Medicines Health.Bavencio [Internet].https:\/\/www.ema.europa.eu\/en\/medicines\/human\/summaries-opinion\/bavencio-0"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41669-018-0115-y"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2013.02.002"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2012.06.012"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2005.00045.x"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.23.1548"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-016-2301-6"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.42.1529"},{"issue":"4","key":"e_1_2_11_25_1","first-page":"879","article-title":"Comparison of cisplatin\u2010paclitaxel combination versus cisplatin\u2010etoposide in patients with small\u2010cell lung cancer: a phase III study","volume":"20","author":"Dimitroulis J","year":"2008","journal-title":"Oncol Rep"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2014.10.002"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.44.5585"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2354.2001.00272.x"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.54.5392"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2014.32.15_suppl.7519"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/55.11.M684"},{"key":"e_1_2_11_32_1","unstructured":"National Health Insurance Administration Online.[Internet].https:\/\/www.nhi.gov.tw\/QueryN\/Query1.aspx"},{"key":"e_1_2_11_33_1","unstructured":"National Health Insurance Administration Medical Services Online.[Internet].https:\/\/www.nhi.gov.tw\/english\/Content_List.aspx?n=1D1ECC54F86E9050&topn=1D1ECC54F86E9050"},{"key":"e_1_2_11_34_1","unstructured":"National Health Insurance Annual Medical Expenses Reports.[Internet].https:\/\/www.nhi.gov.tw\/query\/query2.aspx?n=6A7346FAE90CAF3F&sms=36A0BB334ECB4011&topn=5FE8C9FEAE863B46"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000005216"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.3564"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2018.00086"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2019.09.578"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.6030\/1939-067X-3.1.8"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737167.2017.1330152"}],"container-title":["Cancer Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.1399","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cnr2.1399","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.1399","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T08:14:27Z","timestamp":1693210467000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cnr2.1399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,2]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1002\/cnr2.1399"],"URL":"https:\/\/doi.org\/10.1002\/cnr2.1399","archive":["Portico"],"relation":{},"ISSN":["2573-8348","2573-8348"],"issn-type":[{"value":"2573-8348","type":"print"},{"value":"2573-8348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,2]]},"assertion":[{"value":"2020-12-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e1399"}}