FROM INTENTION TO IMPLEMENTATION: A SYSTEMATIC REVIEW OF THE SOCIETAL PERSPECTIVE IN COST-EFFECTIVENESS ANALYSES OF NON-SMALL CELL LUNG CANCER THERAPIES
Author(s)
Xiaomo (Shawn) Xiong, MS, PhD1, Eszter Garami, MPharm1, Zhanghe Chen, MS1, Z. Kevin Lu, PhD2;
1James L Winkle College of Pharmacy, University of Cincinnati, Division of Pharmacy Practice and Administrative Sciences, Cincinnati, OH, USA, 2College of Pharmacy, University of South Carolina, Department of Clinical Pharmacy and Outcomes Sciences, Columbia, SC, USA
1James L Winkle College of Pharmacy, University of Cincinnati, Division of Pharmacy Practice and Administrative Sciences, Cincinnati, OH, USA, 2College of Pharmacy, University of South Carolina, Department of Clinical Pharmacy and Outcomes Sciences, Columbia, SC, USA
OBJECTIVES: Societal perspectives are increasingly recommended in economic evaluations; however, their application in oncology remains inconsistent. This systematic review aimed to examine how cost-effectiveness analyses (CEAs) of non-small cell lung cancer (NSCLC) therapies have incorporated and reported cost components from a societal perspective.
METHODS: A systematic literature review was conducted in PubMed and Embase to identify CEAs of NSCLC therapies adopting a societal perspective (2010 to 2025). Two reviewers independently screened titles, abstracts, and full texts using predefined criteria. Eligible CEAs explicitly reported the use of a societal perspective. Data on non-medical and indirect costs, sources, and sensitivity analyses were extracted and descriptively summarized to characterize inclusion patterns of societal cost components across regions.
RESULTS: A total of 2,765 records were identified, with 1,464 abstracts screened after duplicate removal. Of these, 291 underwent full-text review, and 20 CEAs published between 2010 and 2025 met the inclusion criteria. Productivity or patient time loss was reported in 11 studies (55%), while caregiver costs appeared in 4 studies (20%). Direct non-medical costs were included in 7 studies (35%) and typically accounted for less than 5% of total costs. Asian studies (n = 9, 45%), particularly from China and Thailand, more often used survey-based patient or caregiver data, while European (n = 6, 30%) and North American (n = 5, 25%) studies relied on national costing manuals or payer databases.
CONCLUSIONS: The implementation of the societal perspective in oncology CEAs was inconsistent. Most studies focused primarily on direct medical costs, with limited inclusion of indirect or non-medical components. Clearer methodological standards and more transparent reporting are needed to ensure that oncology CEAs fully capture the societal economic impact.
METHODS: A systematic literature review was conducted in PubMed and Embase to identify CEAs of NSCLC therapies adopting a societal perspective (2010 to 2025). Two reviewers independently screened titles, abstracts, and full texts using predefined criteria. Eligible CEAs explicitly reported the use of a societal perspective. Data on non-medical and indirect costs, sources, and sensitivity analyses were extracted and descriptively summarized to characterize inclusion patterns of societal cost components across regions.
RESULTS: A total of 2,765 records were identified, with 1,464 abstracts screened after duplicate removal. Of these, 291 underwent full-text review, and 20 CEAs published between 2010 and 2025 met the inclusion criteria. Productivity or patient time loss was reported in 11 studies (55%), while caregiver costs appeared in 4 studies (20%). Direct non-medical costs were included in 7 studies (35%) and typically accounted for less than 5% of total costs. Asian studies (n = 9, 45%), particularly from China and Thailand, more often used survey-based patient or caregiver data, while European (n = 6, 30%) and North American (n = 5, 25%) studies relied on national costing manuals or payer databases.
CONCLUSIONS: The implementation of the societal perspective in oncology CEAs was inconsistent. Most studies focused primarily on direct medical costs, with limited inclusion of indirect or non-medical components. Clearer methodological standards and more transparent reporting are needed to ensure that oncology CEAs fully capture the societal economic impact.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
MSR223
Topic
Methodological & Statistical Research
Disease
SDC: Oncology, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)