Global representativeness and impact of funding sources in cost-effectiveness research on systemic therapies for advanced breast cancer: A systematic review.

Autor: Lazar Neto F; Instituto do Câncer do Estado de São Paulo, ICESP, Universidade de São Paulo, São Paulo, Brazil. Electronic address: felippe.neto@alumni.usp.br., de Melo MAZ; Instituto do Câncer do Estado de São Paulo, ICESP, Universidade de São Paulo, São Paulo, Brazil., Hidalgo Filho CMT; Instituto do Câncer do Estado de São Paulo, ICESP, Universidade de São Paulo, São Paulo, Brazil., Mathias-Machado MC; Instituto do Câncer do Estado de São Paulo, ICESP, Universidade de São Paulo, São Paulo, Brazil; Oncoclinicas, São Paulo, Brazil., Testa L; Instituto do Câncer do Estado de São Paulo, ICESP, Universidade de São Paulo, São Paulo, Brazil., Campolina AG; Instituto do Câncer do Estado de São Paulo, ICESP, Universidade de São Paulo, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Breast (Edinburgh, Scotland) [Breast] 2024 Jun; Vol. 75, pp. 103727. Date of Electronic Publication: 2024 Apr 05.
DOI: 10.1016/j.breast.2024.103727
Abstrakt: Background: Breast cancer (BC) is the most incident tumor and, consequently, any new intervention can potentially promote a considerable budget impact if incorporated. Cost-effectiveness (CE) studies assist in the decision-making process but may be influenced by the country's perspective of analysis and pharmaceutical industry funding.
Methods: A systematic review of Medline, Scopus, and Web of Science from January 1st, 2012 to July 8th, 2022 was conducted to identify CE studies of tumor-targeted systemic-therapies for advanced BC. Articles without incremental cost-effectiveness ratio calculations were excluded. We extracted information on the country and class of drug studied, comparator type, authors' conflicts of interest (COI), pharmaceutical industry funding, and authors' conclusions.
Results: 71 studies comprising 204 CE assessments were included. The majority of studies were from the United States and Canada (44%), Asia (32%) and Europe (20%). Only 8% were from Latin America and none from Africa. 31% had pharmaceutical industry funding. The most studied drug classes were cyclin-dependent-kinase inhibitors (29%), anti-HER2 therapy (23%), anti-PD(L)1 (11%) and hormone therapy (11%). Overall, 34% of CE assessments had favorable conclusions. Pharmaceutical industry-funded articles had a higher proportion of at least one favorable conclusion (82% vs. 24%, p-value<0.001), European countries analyzed (45% vs. 9%, p-value = 0.003), and CE assessments with same class drug comparators (56% vs. 33%, p-value = 0.004).
Conclusions: Breast cancer CE literature scarcely represents low-and-middle-income countries' perspectives and is influenced by pharmaceutical industry funding which targets European countries', frequently utilizes comparisons within same-drug class, and is more likely to have favorable conclusions.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:FLN, MAZM, CMTHF, and AGC have no conflicts of interest to disclose. MCMM has received payment for lectures from Lilly and MSD. The author has received support for attending meetings from Pfizer. LT provides advisory/consulting assistance to MSD, Daiichi Sankyo/Astra Zeneca, Lilly, Pfizer, and Novartis and receives travel accommodation financial support from Gilead, Roche and Astra Zeneca.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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