Effectiveness and cost-effectiveness of combination therapy versus monotherapy in malignant melanoma

Journal of Pharmaceutical Policy and Practice

Review

Melanie Büssgen¹  Dilay Özdemir² 

[1] Hamburg Center for Health Economics, University of Hamburg, Hamburg, Germany;University of Hamburg, Hamburg, Germany;

关键词: Cost-effectiveness;    Effectiveness;    Melanoma;    Malignant melanoma;    Oncology;    Immune checkpoint inhibitors;    BRAF inhibitor;    MEK inhibitor;    Targeted therapy;    Combination therapy;   

DOI  :  10.1186/s40545-023-00611-7

 received in 2022-10-13, accepted in 2023-09-16,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundUntil 2010, stage III or IV malignant melanoma (MM) had a poor prognosis. The discovery of immune checkpoint inhibitors (ICIs) in 2011 changed the treatment landscape. Promising results in patient survival with a checkpoint inhibitor prompted research into combination therapies. In 2016, the first combination therapy has been approved as first-line therapy for advanced MM.ObjectiveThe aim of this work is to investigate to what extent combination therapy is (cost-)effective compared to monotherapy in stage III or IV MM.MethodsA systematic literature search was performed (Web of Science, PubMed, PubPharm, EconLit, and Cochrane Library); searching for publications published over the past decade that examine the cost-effectiveness in terms of cost/QALY and the effectiveness in terms of survival and response of combination therapy in comparison to monotherapy in stage III or IV MM patients.ResultsA total of 11 randomized controlled trials (RCTs) and five cost–utility analyses met our inclusion criteria. Nine clinical trials demonstrated superiority of combination therapy over monotherapy. The combination of B-rapidly accelerated fibrosarcoma (BRAF) protein and mitogen-activated kinase (MEK) protein inhibitors is not cost-effective in any country. Three analyses demonstrate the cost-effectiveness of combination therapy with ICI compared to monotherapy.ConclusionCombination therapy is more effective compared to monotherapy. While combined ICIs are cost-effective compared to monotherapy, this is not the case for the combination of BRAF and MEK inhibitors.

【 授权许可】

CC BY   
© Dr. Zaheer-Ud-Din Babar and Auckland UniServices Ltd. 2023

【 图 表 】

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