OBJECTIVES : Cancer is a leading cause of death for children and adolescents in the developed world. Economic evaluations (EE) are increasingly being used to assist decision makers in the allocation of finite resources, such as life-saving treatments, for children and adolescents diagnosed with cancer. The objectives of this literature review were to quantify methods of cost studies in pediatric oncology EEs and classify attributes of EEs published in the health literature.

METHODS : A narrative literature search of MEDLINE from 2010 to 2019 was conducted using a pre-specified list of search terms. Studies were eligible for inclusion if they met the following criteria: pediatric patients (<18 years of age), oncology-focused, published in the English language, and reported on the findings of an EE (e.g. cost-effectiveness models or cost-of-illness studies).

RESULTS : Initial literature search consisted of 2,138 articles of which 71 met final inclusion criteria. Articles published in 2017 and 2018 accounted for the greatest proportion of EE, 15.5% and 22.5%, respectively. Thirty-five EEs were categorized as cost-of-illness studies representing 49.2% (n=35) of included articles while cost-utility analysis (CUA) represented 4.5% (n=3). Cost-effective analysis (CEAs) were reported in 35.2% of articles. EEs were frequently conducted with regards to Chimeric Antigen Receptor T-Cell therapy, hematopoietic and stem cell transplantation, and acute lymphoblastic leukemia. Markov Modeling approach was reported in five publications meeting the final inclusion criteria. Patient heterogeneity was observed, and methodological limitations were common across all EE types.

CONCLUSIONS : Variability exists in the type of EEs reported in the literature regarding pediatric oncology making evidence synthesis challenging. A significant opportunity remains for specific EEs such as CUAs and CEAs to elucidate the most efficient use of monetary resources and demonstrate value to decision makers.