A comprehensive review of economic evaluations of therapeutic drug monitoring interventions for cancer treatments

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Vithanachchi, Dinusha T
Maujean, Annick
Downes, Martin J
Scuffham, Paul
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2020
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Abstract

Therapeutic drug monitoring (TDM) of cancer drugs has been shown to improve treatment effectiveness and safety. The aim of this paper was to comprehensively review economic evaluations of TDM interventions for cancer drugs. Searches were conducted in four electronic databases, Medline, EMBASE, and Centre for Reviews and Dissemination (CRD) databases’ Database of Abstracts of Reviews of Effects (DARE) and the NHS Economic Evaluation Database (NHS EED), from their inception to June 2019. Studies were included if they were economic evaluations of TDM interventions for an active cancer treatment. The quality of reporting of economic evaluations was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS checklist). Of the 11 publications identified, imatinib with TDM and 5­fluorouracil (5‐FU) with TDM were the most commonly assessed interventions (4 publications each). Overall Study quality was good, with publications meeting 61% to 91% (median 80%) of CHEERS checklist criteria. A variety of studies were used to estimate the clinical effectiveness inputs for the cost effectiveness models. All publications considered TDM to be cost‐effective based on an ICER below the WTP threshold (64%) or being cost‐saving (36%). TDM interventions were considered cost‐effective across the economic evaluations. Further clinical research assessing the impact of TDM on overall survival or other long‐term health outcomes may enhance the evidence base for TDM in oncology. Future economic evaluations of TDM should explicitly consider uncertainty in the underlying clinical evidence and incorporate changes in the use of newer targeted drugs that form the current standard of care.

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British Journal of Clinical Pharmacology

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APP1135054

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© 2020 The British Pharmacological Society. This is the peer reviewed version of the following article: A comprehensive review of economic evaluations of therapeutic drug monitoring interventions for cancer treatments, British Journal of Clinical Pharmacology, Early ViewR, which has been published in final form at 10.1111/bcp.14494. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)

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Subject

Pharmacology and pharmaceutical sciences

cancer

cost-effectiveness

fluorouracil

imatinib

therapeutic drug monitoring

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Vithanachchi, DT; Maujean, A; Downes, MJ; Scuffham, P, A comprehensive review of economic evaluations of therapeutic drug monitoring interventions for cancer treatments., British Journal of Clinical Pharmacology, 2020

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