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Abstract
Introduction Platinum-resistant or -refractory ovarian cancer (PROC) is associated with a considerable economic burden, including high costs of treatment. Here we present the results from an update of a systematic literature review (SLR) conducted to characterize the costs associated with the management of PROC.
Methods The initial SLR included studies published January 2010-July 6, 2021, and the current update included studies from July 2021 to March 2, 2023. MEDLINE®, Embase®, EconLit, Cochrane, and relevant conference proceedings were searched for economic evaluations and studies reporting costs associated with the treatment of advanced ovarian cancer recurring within six months of the last platinum-based chemotherapy. The SLR was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.
Results A total of 19 records from 18 studies were included, two of which were US cost-effectiveness analyses (CEAs) from the updated SLR. A 2022 US CEA reported that olaparib was cost-effective vs niraparib for BRCA1 and BRCA2-mutation-positive PROC at a willingness-to-pay threshold of $100,000. In another CEA from 2022, total parenteral nutrition was not cost-effective for the management of inoperable malignant bowel obstruction in PROC. Overall, the cost-per-cycle for PROC treatment ranged from $53 to $4,360 for chemotherapy, $6,989 to $9,806 for bevacizumab, and $7,780 to $9,022 for poly-(adenosine diphosphate-ribose) polymerase inhibitors (figure 1). Reported incremental cost-effectiveness ratios were high and most interventions were not considered cost effective (table 1).
Conclusion/Implications High healthcare and treatment costs associated with the management of PROC emphasize the need for cost-effective treatment options in PROC.
Cost-effectiveness of PROC therapies reported in the studies included in the SLR