Rapid Review of Real-World Cost-Effectiveness Analyses of Cancer Interventions in Canada

Abstract

Cost-effectiveness analysis (CE Analysis) provides evidence about the incremental gains in patient outcomes costs from new treatments and interventions in cancer care. The utilization of "real-world" data allows these analyses to better reflect differences in costs and effects for actual patient populations with comorbidities and a range of ages as opposed to randomized controlled trials, which use a restricted population. This rapid review was done through PubMed and Google Scholar in July 2022. Relevant articles were summarized and data extracted to summarize changes in costs (in 2022 CAD) and effectiveness in cancer care once funded by the Canadian government payer system. We conducted statistical analyses to examine the differences between means and medians of costs, effects, and incremental cost effectiveness ratios (ICERs). Twenty-two studies were selected for review. Of those, the majority performed a CE Analysis on cancer drugs. Real-world cancer drug studies had significantly higher costs and effects than non-drug therapies. Studies that utilized a model to project longer time-horizons saw significantly smaller ICER values for the treatments they examined. Further, differences in drug costs increased over time. This review highlights the importance of performing real-world CE Analysis on cancer treatments to better understand their costs and impacts on a general patient population.

Keywords: cancer; cancer interventions; cost-effectiveness; economic evaluation; healthcare; real-world interventions.

Figure 1

Flowchart of literature search and selection.

Figure 2

Estimates of Extra Costs and Extra Effects in real world studies of drugs. Q or L indicate QALYs and Life Years estimates of ΔE from a Model. In contrast, q or l indicate qalys and life years estimates of ΔE from a person-level analysis (non-Model). Data are only from studies of drugs.