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Immunotherapy Cost-Effectiveness Varies By Cancer Type
TOPLINE:
A systematic review of 69 economic evaluations revealed that adjuvant immunotherapy was cost-effective in 58% of studies, with higher Quality-Adjusted Life-Year gains reported in 91% of cases. Cost-effectiveness varied significantly by cancer type, treatment strategy, and healthcare system context, with industry-funded studies more likely to report favorable outcomes.
METHODOLOGY:
- Multiple phase 3 trials have shown improved survival and reduced recurrence with adjuvant immunotherapy in various cancers. But the high cost of immunotherapy treatments, often exceeding $100,000 per patient, has raised questions about their economic value and affordability across different healthcare systems.
- Researchers conducted a systematic review of 69 economic evaluations published between January 2015 and January 2025, focusing on adjuvant immunotherapy across various cancer types.
- Analysis included studies from PubMed, Embase, Scopus, Web of Science, and Cochrane Library, with most evaluations conducted in the US (26 studies) and China (20 studies).
- Quality assessment utilized the Criteria for Health Economic Quality Evaluation tool, evaluating 48 attributes across methodologic and reporting quality dimensions.
- Markov modeling dominated the analytical approach (46 studies [67%]), with EuroQol Five-Dimensions being the most commonly used health utility instrument (56 studies [81%]).
TAKEAWAY:
- Of 69 studies analyzed, 58% concluded that adjuvant immunotherapy was cost-effective, with stronger evidence in non-small cell lung cancer and melanoma, particularly in early-stage and high-risk populations.
- Industry-funded studies more frequently reported cost-effective outcomes (17 of 20 studies [85%]) than nonindustry funded studies (13 of 28 studies [46%]).
- Higher Quality-Adjusted Life-Year/Life-Year gains were consistently reported in the adjuvant immunotherapy group (63 studies [91%]), especially for non-small cell lung cancer and combination regimens.
- Cost-effectiveness results varied significantly by cancer type, model assumptions, drug pricing, funding organizations, and country-specific willingness-to-pay thresholds.
IN PRACTICE:
“From a policy standpoint, the findings of this systematic review support the use of structured, context-specific health technology assessment frameworks to evaluate adjuvant immunotherapies. For health systems under financial constraints, prioritizing subgroups with the highest absolute benefit may be a viable approach to ensure sustainable access,” the authors of the review wrote.
SOURCE:
The systematic review was led by Rashidul Alam Mahumud, PhD, MCncrSc, MPH, MSc, Health Economics and Health Technology Assessment Unit, National Health and Medical Research Council Clinical Trials Centre, The University of Sydney in Camperdown, Australia. It was published online on January 22 in JAMA Oncology.
LIMITATIONS:
The methodologic heterogeneity across studies presents a significant limitation, with variations in time horizons, discounting methods, survival data extrapolation, and health utility measurements affecting result comparability. Geographic distribution primarily focused on high-income countries, limiting generalizability to low- and middle-income settings. Few evaluations incorporated adaptive pricing schemes or managed entry agreements that increasingly influence clinical reimbursement decisions.
DISCLOSURES:
Mahumud had full access to all study data and takes responsibility for data integrity and analysis accuracy. The authors reported having no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
A version of this article first appeared on Medscape.com.
TOPLINE:
A systematic review of 69 economic evaluations revealed that adjuvant immunotherapy was cost-effective in 58% of studies, with higher Quality-Adjusted Life-Year gains reported in 91% of cases. Cost-effectiveness varied significantly by cancer type, treatment strategy, and healthcare system context, with industry-funded studies more likely to report favorable outcomes.
METHODOLOGY:
- Multiple phase 3 trials have shown improved survival and reduced recurrence with adjuvant immunotherapy in various cancers. But the high cost of immunotherapy treatments, often exceeding $100,000 per patient, has raised questions about their economic value and affordability across different healthcare systems.
- Researchers conducted a systematic review of 69 economic evaluations published between January 2015 and January 2025, focusing on adjuvant immunotherapy across various cancer types.
- Analysis included studies from PubMed, Embase, Scopus, Web of Science, and Cochrane Library, with most evaluations conducted in the US (26 studies) and China (20 studies).
- Quality assessment utilized the Criteria for Health Economic Quality Evaluation tool, evaluating 48 attributes across methodologic and reporting quality dimensions.
- Markov modeling dominated the analytical approach (46 studies [67%]), with EuroQol Five-Dimensions being the most commonly used health utility instrument (56 studies [81%]).
TAKEAWAY:
- Of 69 studies analyzed, 58% concluded that adjuvant immunotherapy was cost-effective, with stronger evidence in non-small cell lung cancer and melanoma, particularly in early-stage and high-risk populations.
- Industry-funded studies more frequently reported cost-effective outcomes (17 of 20 studies [85%]) than nonindustry funded studies (13 of 28 studies [46%]).
- Higher Quality-Adjusted Life-Year/Life-Year gains were consistently reported in the adjuvant immunotherapy group (63 studies [91%]), especially for non-small cell lung cancer and combination regimens.
- Cost-effectiveness results varied significantly by cancer type, model assumptions, drug pricing, funding organizations, and country-specific willingness-to-pay thresholds.
IN PRACTICE:
“From a policy standpoint, the findings of this systematic review support the use of structured, context-specific health technology assessment frameworks to evaluate adjuvant immunotherapies. For health systems under financial constraints, prioritizing subgroups with the highest absolute benefit may be a viable approach to ensure sustainable access,” the authors of the review wrote.
SOURCE:
The systematic review was led by Rashidul Alam Mahumud, PhD, MCncrSc, MPH, MSc, Health Economics and Health Technology Assessment Unit, National Health and Medical Research Council Clinical Trials Centre, The University of Sydney in Camperdown, Australia. It was published online on January 22 in JAMA Oncology.
LIMITATIONS:
The methodologic heterogeneity across studies presents a significant limitation, with variations in time horizons, discounting methods, survival data extrapolation, and health utility measurements affecting result comparability. Geographic distribution primarily focused on high-income countries, limiting generalizability to low- and middle-income settings. Few evaluations incorporated adaptive pricing schemes or managed entry agreements that increasingly influence clinical reimbursement decisions.
DISCLOSURES:
Mahumud had full access to all study data and takes responsibility for data integrity and analysis accuracy. The authors reported having no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
A version of this article first appeared on Medscape.com.
TOPLINE:
A systematic review of 69 economic evaluations revealed that adjuvant immunotherapy was cost-effective in 58% of studies, with higher Quality-Adjusted Life-Year gains reported in 91% of cases. Cost-effectiveness varied significantly by cancer type, treatment strategy, and healthcare system context, with industry-funded studies more likely to report favorable outcomes.
METHODOLOGY:
- Multiple phase 3 trials have shown improved survival and reduced recurrence with adjuvant immunotherapy in various cancers. But the high cost of immunotherapy treatments, often exceeding $100,000 per patient, has raised questions about their economic value and affordability across different healthcare systems.
- Researchers conducted a systematic review of 69 economic evaluations published between January 2015 and January 2025, focusing on adjuvant immunotherapy across various cancer types.
- Analysis included studies from PubMed, Embase, Scopus, Web of Science, and Cochrane Library, with most evaluations conducted in the US (26 studies) and China (20 studies).
- Quality assessment utilized the Criteria for Health Economic Quality Evaluation tool, evaluating 48 attributes across methodologic and reporting quality dimensions.
- Markov modeling dominated the analytical approach (46 studies [67%]), with EuroQol Five-Dimensions being the most commonly used health utility instrument (56 studies [81%]).
TAKEAWAY:
- Of 69 studies analyzed, 58% concluded that adjuvant immunotherapy was cost-effective, with stronger evidence in non-small cell lung cancer and melanoma, particularly in early-stage and high-risk populations.
- Industry-funded studies more frequently reported cost-effective outcomes (17 of 20 studies [85%]) than nonindustry funded studies (13 of 28 studies [46%]).
- Higher Quality-Adjusted Life-Year/Life-Year gains were consistently reported in the adjuvant immunotherapy group (63 studies [91%]), especially for non-small cell lung cancer and combination regimens.
- Cost-effectiveness results varied significantly by cancer type, model assumptions, drug pricing, funding organizations, and country-specific willingness-to-pay thresholds.
IN PRACTICE:
“From a policy standpoint, the findings of this systematic review support the use of structured, context-specific health technology assessment frameworks to evaluate adjuvant immunotherapies. For health systems under financial constraints, prioritizing subgroups with the highest absolute benefit may be a viable approach to ensure sustainable access,” the authors of the review wrote.
SOURCE:
The systematic review was led by Rashidul Alam Mahumud, PhD, MCncrSc, MPH, MSc, Health Economics and Health Technology Assessment Unit, National Health and Medical Research Council Clinical Trials Centre, The University of Sydney in Camperdown, Australia. It was published online on January 22 in JAMA Oncology.
LIMITATIONS:
The methodologic heterogeneity across studies presents a significant limitation, with variations in time horizons, discounting methods, survival data extrapolation, and health utility measurements affecting result comparability. Geographic distribution primarily focused on high-income countries, limiting generalizability to low- and middle-income settings. Few evaluations incorporated adaptive pricing schemes or managed entry agreements that increasingly influence clinical reimbursement decisions.
DISCLOSURES:
Mahumud had full access to all study data and takes responsibility for data integrity and analysis accuracy. The authors reported having no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
A version of this article first appeared on Medscape.com.
Immunotherapy Cost-Effectiveness Varies By Cancer Type
Immunotherapy Cost-Effectiveness Varies By Cancer Type