Economic analyses of immune-checkpoint inhibitors to treat lung cancer

ABSTRACT

Introduction: Total lung-cancer–management costs are increasing dramatically. The widespread use of immune-checkpoint inhibitors (ICIs) explains this rise in large part and financially impacts healthcare systems. Economic assessment has been adapted to this new challenge.

Areas covered: This review provides an overview of the economic literature on the use of ICIs to treat lung cancer. Numerous papers have been published over the last few years. Cancers analyzed were non-squamous non-small-cell lung cancer (NSCLC), squamous NSCLC, locally advanced NSCLC, or small-cell lung cancer.

Expert commentary: For the majority of patients, ICIs are cost-effective for lung cancer management. However, these results are influenced by the threshold chosen by each of the different countries. Patient selection, treatment duration, and factors predictive of efficacy are mandatory to decrease costs.

KEYWORDS:

• Lung cancer
• metastatic disease
• immune-checkpoint inhibitors
• economics
• cost-effectiveness

ARTICLE HIGHLIGHTS

• The cost of treating lung cancer with immune-checkpoint inhibitors (ICIs) is increasing dramatically

• These agents have notable consequences on societies’ budgets

• The threshold chosen markedly affected the cost-effectiveness outcome

• Global costs will double between 2020 and 2040

• Second-line ICI expenditures/Quality-adjusted life year (QALY) are frequently cost-effective

• First-line ICI economic study findings vary among the different countries in terms of incremental cost-effectiveness ratio (ICER)

• • Selecting patients most likely to benefit from ICIs is mandatory to decrease costs

• Economic analyses must be included in the market-access process

Declaration of interest

A Vergnenègre has been a consultant and on advisory boards for MSD, Hoffman Laroche, BMS, Pierre-Fabre Oncology, and AstraZeneca; and an invited speaker for AstraZeneca, Boehringer Ingelheim, MSD, Pierre-Fabre Oncology. C Chouaïd has received fees or funding from AstraZeneca, Boehringer Ingelheim, GSK, Rock, MSD, BMS, Lilly, Pfizer, Pierre-Fabre Oncology, Novartis and Amgen for participation in conferences, communications, training activities, research work, participation in expert groups, writing articles or documents, advice and expertise. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers Disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.