IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0238536.html
   My bibliography  Save this article

Cost effectiveness of immune checkpoint inhibitors for treatment of non-small cell lung cancer: A systematic review

Author

Listed:
  • Haiying Ding
  • Wenxiu Xin
  • Yinghui Tong
  • Jiao Sun
  • Gaoqi Xu
  • Ziqi Ye
  • Yuefeng Rao

Abstract

Background: Immune checkpoint inhibitors (ICIs) for treatment of non-small cell lung cancer (NSCLC) have been rapidly evolving. ICIs are likely to be more effective but also lead to escalating healthcare costs. Objectives: The aim of this study was to evaluate the cost effectiveness of immune checkpoint inhibitors (ICIs) for treatment of non-small cell lung cancer (NSCLC). Methods: We searched the PubMed, Web of Science, and Cochrane Library for studies comparing the cost effectiveness of ICIs for NSCLC. Potential studies identified were independently checked for eligibility by two authors, with disagreement resolved by a third reviewer. Quality of the included studies was evaluated using Consolidated Health Economic Evaluation Reporting Standards checklists. Results: A total of 22 economic studies were included. Overall reporting of the identified studies largely met CHEERS recommendations. In the first-line setting, for advanced or metastatic NSCLC patients with PD-L1 ≥ 50%, pembrolizumab appeared cost-effective compared with platinum-based chemotherapy in the US and Hong Kong (China), but not in the UK and China. The cost-effectiveness of pembrolizumab versus chemotherapy for first-line treatment of NSCLC in PD-L1 ≥ 1% patients remained obscure. Regardless of PD-L1 expression status, pembrolizumab in combination with chemotherapy could be a cost-effective first-line therapy in the US. On the contrary, addition of atezolizumab to the combination of bevacizumab and chemotherapy was not cost-effective for patients with metastatic non-squamous NSCLC from the US payer perspective. In the second-line setting compared with docetaxel, pembrolizumab was cost-effective; though nivolumab was not cost-effective in the base case, it could be by increased PD-L1 threshold. Results of the cost-effectiveness of atezolizumab second-line treatment remained inconsistent. In addition, the adoption of durvalumab consolidation therapy after chemoradiotherapy could be cost-effective versus no consolidation therapy for patients with stage III NSCLC. Conclusions: Immunotherapy can be a cost-effective option for treatment of NSCLC in several scenarios. A discount of the agents or the use of PD-L1 expression as a biomarker improves the cost-effectiveness of immunotherapy.

Suggested Citation

  • Haiying Ding & Wenxiu Xin & Yinghui Tong & Jiao Sun & Gaoqi Xu & Ziqi Ye & Yuefeng Rao, 2020. "Cost effectiveness of immune checkpoint inhibitors for treatment of non-small cell lung cancer: A systematic review," PLOS ONE, Public Library of Science, vol. 15(9), pages 1-16, September.
    • Handle: RePEc:plo:pone00:0238536
    DOI: 10.1371/journal.pone.0238536
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238536
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0238536&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0238536?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Paul T E Cusack, 2020. "On Pain," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 31(3), pages 24253-24254, October.
    2. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(3), pages 367-372, June.
    3. Christos Chouaid & Lionel Bensimon & Emilie Clay & Aurélie Millier & Laurie Levy-Bachelot & Min Huang & Pierre Lévy, 2019. "Cost-effectiveness analysis of pembrolizumab versus standard-of-care chemotherapy for first-line treatment of PD-L1 positive (>50%) metastatic squamous and non-squamous non-small cell lung cancer in F," Post-Print hal-02273984, HAL.
    4. Natalia Ruiz-Negrón & Jyothi Menon & Jordan B. King & Junjie Ma & Brandon K. Bellows, 2019. "Cost-Effectiveness of Treatment Options for Neuropathic Pain: a Systematic Review," PharmacoEconomics, Springer, vol. 37(5), pages 669-688, May.
    5. Sergio Iannazzo & Ange-Christelle Iliza & Louise Perrault, 2018. "Disease-Modifying Therapies for Multiple Sclerosis: A Systematic Literature Review of Cost-Effectiveness Studies," PharmacoEconomics, Springer, vol. 36(2), pages 189-204, February.
    6. Min Huang & Yanyan Lou & James Pellissier & Thomas Burke & Frank Xiaoqing Liu & Ruifeng Xu & Vamsidhar Velcheti, 2017. "Cost Effectiveness of Pembrolizumab vs. Standard-of-Care Chemotherapy as First-Line Treatment for Metastatic NSCLC that Expresses High Levels of PD-L1 in the United States," PharmacoEconomics, Springer, vol. 35(8), pages 831-844, August.
    7. Lan Gao & Shu-Chuen Li, 2019. "Modelled Economic Evaluation of Nivolumab for the Treatment of Second-Line Advanced or Metastatic Squamous Non-Small-Cell Lung Cancer in Australia Using Both Partition Survival and Markov Models," Applied Health Economics and Health Policy, Springer, vol. 17(3), pages 371-380, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Boshen Jiao & Anirban Basu & Joshua Roth & M. Bender & Ilsa Rovira & Traci Clemons & Dalyna Quach & Scott Ramsey & Beth Devine, 2021. "The Use of Cost-Effectiveness Analysis in Sickle Cell Disease: A Critical Review of the Literature," PharmacoEconomics, Springer, vol. 39(11), pages 1225-1241, November.
    2. B Ekman & H Nero & L S Lohmander & L E Dahlberg, 2020. "Costing analysis of a digital first-line treatment platform for patients with knee and hip osteoarthritis in Sweden," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-12, August.
    3. Michaela Carla Barbier & Esther Pardo & Cédric Michael Panje & Oliver Gautschi & Judith Eva Lupatsch, 2021. "A cost-effectiveness analysis of pembrolizumab with or without chemotherapy for the treatment of patients with metastatic, non-squamous non-small cell lung cancer and high PD-L1 expression in Switzerl," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 669-677, July.
    4. Carmen Selva-Sevilla & F Dámaso Fernández-Ginés & Manuel Cortiñas-Sáenz & Manuel Gerónimo-Pardo, 2021. "Cost-effectiveness analysis of domiciliary topical sevoflurane for painful leg ulcers," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-18, September.
    5. Giovanna Elisa Calabrò & Sara Boccalini & Donatella Panatto & Caterina Rizzo & Maria Luisa Di Pietro & Fasika Molla Abreha & Marco Ajelli & Daniela Amicizia & Angela Bechini & Irene Giacchetta & Piero, 2022. "The New Quadrivalent Adjuvanted Influenza Vaccine for the Italian Elderly: A Health Technology Assessment," IJERPH, MDPI, vol. 19(7), pages 1-14, March.
    6. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Interventions for Screening of Dementia," Working Papers 2018:20, Lund University, Department of Economics.
    7. Daniel Niederer & Juliane Mueller, 2020. "Sustainability effects of motor control stabilisation exercises on pain and function in chronic nonspecific low back pain patients: A systematic review with meta-analysis and meta-regression," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-21, January.
    8. Sana Sadiq & Khadija Anasse & Najib Slimani, 2022. "The impact of mobile phones on high school students: connecting the research dots," Technium Social Sciences Journal, Technium Science, vol. 30(1), pages 252-270, April.
    9. Jitka Vseteckova, 2020. "Psychological Therapy for ICT Literate Older Adults in the Time of COVID-19 - Perceptions on the Acceptability of Online Versus Face to Face Versions of a Mindfulness for Later Life Group," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 31(1), pages 23912-23916, October.
    10. Khalid Ahmed Al-Ansari & Ahmet Faruk Aysan, 2021. "More than ten years of Blockchain creation: How did we use the technology and which direction is the research heading? [Plus de dix ans de création Blockchain : Comment avons-nous utilisé la techno," Working Papers hal-03343048, HAL.
    11. Ling, Gabriel Hoh Teck & Suhud, Nur Amiera binti Md & Leng, Pau Chung & Yeo, Lee Bak & Cheng, Chin Tiong & Ahmad, Mohd Hamdan Haji & Matusin, AK Mohd Rafiq AK, 2021. "Factors Influencing Asia-Pacific Countries’ Success Level in Curbing COVID-19: A Review Using a Social–Ecological System (SES) Framework," SocArXiv b9f2w, Center for Open Science.
    12. Benedict E. DeDominicis, 2021. "Multinational Enterprises And Economic Nationalism: A Strategic Analysis Of Culture," Global Journal of Business Research, The Institute for Business and Finance Research, vol. 15(1), pages 19-66.
    13. Robert J. R. Elliott & Ingmar Schumacher & Cees Withagen, 2020. "Suggestions for a Covid-19 Post-Pandemic Research Agenda in Environmental Economics," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 76(4), pages 1187-1213, August.
    14. Rafał Krupiński, 2020. "Virtual Reality System and Scientific Visualisation for Smart Designing and Evaluating of Lighting," Energies, MDPI, vol. 13(20), pages 1-17, October.
    15. Werner Hölzl & Michael Böheim & Klaus Friesenbichler & Agnes Kügler & Thomas Leoni, 2021. "Staatliche Hilfsmaßnahmen für Unternehmen in der COVID-19-Krise. Eine begleitende Analyse operativer Aspekte und Unternehmenseinschätzungen," WIFO Studies, WIFO, number 66624.
    16. Thorbecke, Willem & Chen, Chen & Salike, Nimesh, 2021. "China’s exports in a protectionist world," Journal of Asian Economics, Elsevier, vol. 77(C).
    17. Óscar Chiva-Bartoll & Honorato Morente-Oria & Francisco Tomás González-Fernández & Pedro Jesús Ruiz-Montero, 2020. "Anxiety and Bodily Pain in Older Women Participants in a Physical Education Program. A Multiple Moderated Mediation Analysis," Sustainability, MDPI, vol. 12(10), pages 1-12, May.
    18. Gigi Foster, 2020. "The behavioural economics of government responses to COVID-19," Journal of Behavioral Economics for Policy, Society for the Advancement of Behavioral Economics (SABE), vol. 4(S3), pages 11-43, December.
    19. Reza Salajegheh & Edward C Nemergut & Terran M Rice & Roy Joseph & Siny Tsang & Bethany M Sarosiek & C Paige Muthusubramanian & Katelyn M Hipwell & Kate B Horton & Bhiken I Naik, 2020. "Impact of a perioperative oral opioid substitution protocol during the nationwide intravenous opioid shortage: A single center, interrupted time series with segmented regression analysis," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-13, June.
    20. Clarke, Lorcan, 2020. "An introduction to economic studies, health emergencies, and COVID-19," LSE Research Online Documents on Economics 105051, London School of Economics and Political Science, LSE Library.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0238536. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.