PCN144 ECONOMIC EVALUATIONS OF CANCER INTERVENTIONS IN SPAIN: LITERATURE REVIEW

Abstract

In the last 2 years a third of the reimbursed drugs in Spain were new antineoplastic and immunomodulating agents. The aim of this study was to review the literature on economic evaluations of health interventions for solid and haematologic tumours in Spain. A literature search of economic evaluations was performed in ICER-eSalud, a database that summarizes cost-effectiveness (CEAs) and cost-utility analyses (CUAs) published in the Spanish setting. Publications were obtained from Spanish and international databases, including Agencias Españolas de Evaluación de Tecnologías Sanitarias, IBECS, PharmacoEconomics Spanish Research Articles, Pubmed, Science Direct, and Centre for Reviews and Dissemination. Studies published from 2008 to 2018 and that evaluated interventions for oncology were included in the analysis. Fifty-two studies of health interventions in different types of tumours met the inclusion criteria. Of these, 28 (54%) analysed pharmaceutical products, 9 (17%) public health programs, 7 (13%) the delivery of care, 5 (10%) surgical procedures, and 3 (6%) medical devices. Among pharmaceutical products, the most frequently evaluated tumours were breast cancer (n=5), non-small cell lung cancer (n=3), colorectal cancer (n=3) and follicular lymphoma (n=3). A total of 31 incremental cost-utility ratios (ICURs) were found. The median ICUR was €21,069/QALY (range min-max: 295-132,198) and 23% of the interventions were dominant (greater utility and lower costs) or cost-saving. At a threshold of €21,000/QALY, approximately 61% of the interventions were cost-effective. Most of the studies evaluated the addition of targeted therapies for cancer in current treatments. Approximately 60% of cancer interventions evaluated were cost-effective in Spain under a threshold of €21,000/QALY. Targeted therapies are emerging approaches for cancer treatment. Thus, the introduction of new drugs should be accompanied by an increase in the number of economic evaluations related to oncology.