Economic evaluations of cancer immunotherapy: a systematic review and quality evaluation.

Abstract

OBJECTIVES:

Scientific advances in the last decade have highlighted the use of immunotherapy, especially immune checkpoint inhibitors, to be an effective strategy in cancer therapy. However, these immunotherapeutic agents are expensive, and their use must take into account economic criteria. Thus, the objective of the present study was to systematically identify and review published EE related to the use of ipilimumab, nivolumab or pembrolizumab in melanoma, lung cancer, head and neck cancer or renal cell carcinoma, and to assess their quality.

METHODS:

The systematic literature research was conducted on Medline via PubMed and the Cochrane Central Register of Controlled Trials to identify economic evaluations published before July 2018. The quality of each selected economic evaluation was assessed by two independent reviewers using the Drummond checklist.

RESULTS:

Our systematic review was based on 32 economic evaluations using different methodological approaches, different perspectives and different time horizons. Three-quarters of the economic evaluations are full (n = 24) with a Drummond score ≥ 7, synonymous of "high quality". Among them, 66% reported a strategy that was cost-effective. The most assessed immunotherapeutic agent was nivolumab. In patients with renal cell carcinoma or head and neck cancer, it was less likely to be cost-effective than in patients with melanoma or lung cancer.

CONCLUSIONS:

Whether or not these findings will be confirmed remains to be seen when market approval to cover more indications is extended and new effective immunotherapeutic agents become available.

• Authors: Charlotte Couchoud, Philippe Fagnoni, François Aubin, Virginie Westeel, Tristan Maurina, Antoine Thiery-Vuillemin, Claire Gerard, Marie Kroemer, Christophe Borg, Samuel Limat, Virginie Nerich
• Journal: Cancer immunology, immunotherapy : CII (Cancer Immunol Immunother) Vol. 69 Issue 10 Pg. 1947-1958 (Oct 2020) ISSN: 1432-0851 [Electronic] Germany
• PMID: 32676716 (Publication Type: Journal Article, Review, Systematic Review)

Chemical References

• Antineoplastic Agents, Immunological

Topics

• Antineoplastic Agents, Immunological (economics, therapeutic use)
• Cost-Benefit Analysis
• Humans
• Immunotherapy (economics)
• Neoplasms (drug therapy, economics, immunology, pathology)
• Prognosis