OBJECTIVES: With the addition of topotecan, gemcitabine, and bevacizumab to the traditional treatment of advanced cervical cancer, there is a need to understand the current economic burden of the disease and economic impact of current care. A systematic literature review was conducted to identify the available data pertaining to the economic evaluations and costs in adult patients with advanced cervical cancer.

METHODS: MEDLINE, EMBASE, conference proceedings, and Cochrane Library were searched using key terms and Medical Subject Headings for cervical cancer, cost, and economic analysis to identify publications in the past 10 years.

RESULTS: Among 3,192 abstracts screened, 29 studies were included with 12 studies containing evidence on economic analysis, and 20 studies on cost and resource use. In the US, treatment of cervical cancer was estimated at $441 million annually in 2010 US dollars. The mean costs for the first and second years after diagnosis were $50,846 and $27,656 (2015 US dollars), respectively. The average total cost of six cycles of cisplatin/paclitaxel (CP) was lower than cisplatin/topotecan, cisplatin/gemcitabine, cisplatin/vinorelbine for the treatment of advanced cervical cancer. Compared with the mean total costs of $33K for CP per patient, addition of bevacizumab to either CP or topotecan/paclitaxel resulted in mean total costs per patient of $97K or $109K, respectively. The incremental cost-effectiveness ratio (ICER) was $12K-$14K per quality-adjusted life year (QALY) for CP versus cisplatin, which was $134k-155K per QALY for CP plus bevacizumab versus CP. Findings of this review suggested that CP was a cost-effective regimen in the treatment of advanced cervical cancer, yet the addition of bevacizumab was far above the conventional threshold of $50K/QALY.

CONCLUSIONS: Cervical cancer is associated with substantial direct and indirect healthcare costs, especially at an advanced stage. The addition of bevacizumab to cisplatin-based therapy resulted in higher per patient treatment costs.