PCN92 - Pharmacoeconomic Evaluations of Oral Anticancer Agents: Thematic Systematic Review

Abstract

The current project sought to analyze the medical literature in relation to published economic evaluations (pharmacoeconomics) of Oral anticancer drugs (OACDs), especially as compared to the parenteral alternatives. This will identify the decision analytic modeling conducted as well as the variety of methods used. Strengths and weaknesses of study designs will be determined, including gaps in knowledge. A thematic systematic review was conducted using the search engines: PubMed, Medline, EconLit, Embase and Economic Evaluation Database. MeSH terms were used under following 3 search domains: therapy, dosage form, research design. Inclusion and exclusion criteria were applied into two stage screening process. Validation tests were conducted for accuracy. A total of 18 studies were deemed eligible for study inclusion. It was found that the pharmacoeconomics evaluations were mostly of cost-utility analyses, and from the payer perspective. Primary sources of clinical and economic data were randomized clinical trials, expert panels and medical charts. In most cases, dominance status was reported in favor of OACDs. Decision analytic modeling was used in the majority of studies, mostly constituting Markov modeling. Sensitivity analyses were conducted in most studies, constituting one-way sensitivity analysis. The types of cancers, where the effect of OACDs was studied, were the metastatic renal carcinoma, gastrointestinal tumors, colon cancer, chronic myeloid leukemia and non-small cell lung cancer. Most included articles were published during the last seven years. Most studies were only conducted in the UK, US and Europe. This is first systematic review of the economic methods used in the evaluation of OACDs. Most important, is that despite the higher acquisition cost, OACDs were demonstrated to be mostly superior over the parenteral alternatives. The pharmacoeconomics studies are difficult to generalize, whereby published economic evaluations are locally specific, especially for the purpose of practical interpretation.