A systematic review of health economic evaluation of targeted therapies for first-line treatment of metastatic non-small cell lung cancer (NSCLC): Quality evaluation

Abstract Backgroud: Evolving practice in non-small cell lung cancer (NSCLC) therapy inevitably impacts health care budgets, especially the introduction of targeted therapies. This results in a rise of health economic evaluations (HEEs) in this domain. The objective of this article is to review the quality of the economic evidence of targeted therapies in metastatic NSCLC. Methods: A literature search using Pubmed, Cochrane, Embase and CRD (University of York Centre for Reviews and Dissemination) database was conducted to identify original articles published between 1/1/2000 and 31/3/2019. A quality of reporting assessment using CHEERS (Consolidated Health Economic Evaluation Reporting Standards statement) was translated into a quantitative score and compared with QHES (Quality of Health Economic Studies) evaluation. Results: Twenty-one HEEs were analyzed. In CHEERS assessment, method description integrity (including setting, perspective, time horizon and discount rate), justification of data sources and heterogeneity description were often absent or incomplete. Only four studies reach the standard of good quality. Modeled articles were mainly evaluated by the QHES instrument, lack of illustrated structure, formula of the transitioning probability and justification for the choice of the model were the most frequent problems in selected studies. After quantification, the CHEERS-scores did not differ significantly from QHES-scores. Conclusion: The overall quality of HEEs in NSCLC targeted therapies is not high. In addition, further efforts are needed to improve the standardization of the model application and the transparency of data description, which is indispensable for valid decision-making on scarce health care resource allocation.