Cost-effectiveness of immune checkpoint inhibitors as a first-line therapy for advanced hepatocellular carcinoma: a systematic review.

IF 2.7 3区经济学 Q1 ECONOMICS

Health Economics Review Pub Date : 2024-07-05 DOI:10.1186/s13561-024-00526-2

Hongyu Gong, Siew Chin Ong, Fan Li, Yan Shen, Zhiying Weng, Keying Zhao, Zhengyou Jiang, Meng Wang

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引用次数: 0

Abstract

Since 2017, immune checkpoint inhibitors (ICIs) have been available for the treatment of advanced hepatocellular carcinoma (HCC) or unresectable HCC, but their adoption into national medical insurance programs is still limited. Cost-effectiveness evidence can help to inform treatment decisions. This systematic review aimed to provide a critical summary of economic evaluations of ICIs as a treatment for advanced HCC and identify key drivers (PROSPERO 2023: CRD42023417391). The databases used included Scopus, Web of Science, PubMed, Embase, and Cochrane Central. Economic evaluations of ICIs for the treatment of advanced HCC were included. Studies were screened by two people. Of the 898 records identified, 17 articles were included. The current evidence showed that ICIs, including atezolizumab plus bevacizumab, sintilimab plus bevacizumab/bevacizumab biosimilar, nivolumab, camrelizumab plus rivoceranib, pembrolizumab plus lenvatinib, tislelizumab, durvalumab, and cabozantinib plus atezolizumab, are probably not cost-effective in comparison with tyrosine kinase inhibitors or other ICIs. The most influential parameters were price of anticancer drugs, hazard ratios for progression-free survival and overall survival, and utility for health statest. Our review demonstrated that ICIs were not a cost-effective intervention in advanced HCC. Although ICIs can significantly enhance the survival of patients with advanced HCC, decision-makers should consider the findings of economic evaluations and affordability before adoption of new therapies.

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免疫检查点抑制剂作为晚期肝细胞癌一线疗法的成本效益：系统综述。

自2017年起，免疫检查点抑制剂（ICIs）开始用于治疗晚期肝细胞癌（HCC）或无法切除的HCC，但其在国家医疗保险计划中的应用仍然有限。成本效益证据有助于为治疗决策提供依据。本系统综述旨在对 ICIs 作为晚期 HCC 治疗方法的经济评估进行批判性总结，并确定关键驱动因素（PROSPERO 2023：CRD42023417391）。使用的数据库包括 Scopus、Web of Science、PubMed、Embase 和 Cochrane Central。纳入了对 ICIs 治疗晚期 HCC 的经济评估。研究由两人进行筛选。在确定的 898 条记录中，共纳入了 17 篇文章。目前的证据显示，与酪氨酸激酶抑制剂或其他 ICIs 相比，ICIs（包括阿特珠单抗联合贝伐单抗、辛替利单抗联合贝伐单抗/贝伐单抗生物类似物、尼沃单抗、卡麦珠单抗联合利伐沙尼、pembrolizumab 联合来伐替尼、tislelizumab、durvalumab 和 cabozantinib 联合阿特珠单抗）可能不具有成本效益。最有影响的参数是抗癌药物的价格、无进展生存期和总生存期的危险比以及健康状况的效用。我们的研究表明，对晚期 HCC 进行干预，ICIs 并不具有成本效益。虽然 ICIs 能显著提高晚期 HCC 患者的生存率，但决策者在采用新疗法之前应考虑经济评估结果和经济承受能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Economics Review Multiple-

CiteScore

3.90

自引率

4.20%

发文量

审稿时长

13 weeks

期刊介绍： Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.