OBJECTIVES: The aim of the study was to perform a systematic review of recently published cost-effectiveness studies on cancer immunotherapy medicines.

METHODS: A systematic literature search in Medline was performed to identify cost-utility and cost-effectiveness studies published between January 2014 and March 2019. We included studies on all immunotherapy medicines authorized in EU for cancer treatment excluding cytokines.

RESULTS: The initial search resulted in 480 studies and 140 studies met the inclusion criteria. Among those 38 were focused on immune checkpoint inhibitors, most of them on nivolumab and pembrolizumab and were published mostly in 2017-2019. The most out of 93 studies on other monoclonal antibodies focused on bevacizumab, rituximab, trastuzumab and cetuximab, respectively. The most covered therapeutic areas were: colorectal cancer, breast cancer and non-small cell lung cancer. The majority of studies (120) were conducted from payer's perspective. Of this 46 in United States of America, 19 in Canada and among European countries, 11 in United Kingdom and 6 in Netherlands. WTP thresholds varied between countries but the most common WTP threshold used in the selected studies was $100,000/QALY gained. The studied intervention was cost-effective in about half of the cases. However, immune checkpoint inhibitors were likely to be cost-effective in the treatment of melanoma and non-small cell lung cancer at WTP $100,000/QALY gained especially when the PD-L1 cut-offs were applied.

CONCLUSIONS: Due to the various study designs and different treatment strategies, therapeutic areas and healthcare systems the results are heterogeneous. Although cancer immunotherapy medicines are typically associated with high prices, they were still shown to be cost-effective in certain subgroups.