OBJECTIVES: Despite recent improvements in the management of solid cancers, the survival rate in malignant pleural mesothelioma (MPM) remains low. Patients often need multiple pleural interventions to diagnose and manage the tumour, resulting in substantial economic burden. The objective of this systematic literature review (SLR) was to identify the cost and healthcare resource utilization (HRU) associated with MPM in Europe.

METHODS: A PRISMA-compliant SLR was conducted using Embase® and MEDLINE® to identify relevant English language publications providing the evidence for economic burden (cost and HRU) associated with patients with MPM. The searches were restricted to English language and published from January 2012–June 2022.

RESULTS: Among 1,944 records screened using PICOS-based criteria, twelve studies evaluating economic burden were included. From a UK healthcare perspective, the mean total cost per-patient per-year (PPPY) ranged between €4,911.69–€5,470.93. In France, the mean (SD) per-patient costs associated with pemetrexed, and bevacizumab treatment was €27,624 (15,894) (cost year 2016). Another French study reported a higher total PPPY cost attributable to occupational risk factors for men (€52,381–€54,548) compared with women (€10,916–€11,290) (cost year 2010). The length of hospital stay was reported to be 5 – 70 days in the UK, further, complications had significant impact on hospital stay [post-operative atrial fibrillation (14 vs 20 days p = 0.037)]. In addition, hospital stay was also impacted by therapeutic options opted. The hospital stay was longer in patients who received video-assisted thoracoscopic partial pleurectomy (VAT-PP) (5–11 days) compared with those who received talc pleurodesis (2–5 days) (p<0·0001).

CONCLUSIONS: Drug utilization costs and occupational risk factors were key cost drivers of the economic burden in patients with MPM. HRU was reported to be impacted by therapeutic options. Further measures are needed to enhance health security for patients with MPM to relieve the economic burden.