Adverse Event Costs and Cost-Effectiveness Analyses of Anticancer Drugs

作者：Mingye Zhao, Taihang Shao, Yue Yin, Hongshu Fang, Hanqiao Shao, Wenxi Tang · 发表于：JAMA Network Open · 年份：2025 · DOI：10.1001/jamanetworkopen.2025.12455 · 被引用次数：10 · 研究领域：Economic and Financial Impacts of Cancer、Health Systems, Economic Evaluations, Quality of Life、Statistical Methods in Clinical Trials

Importance: Accurately quantifying adverse event (AE) costs is essential for cost-effectiveness analyses (CEAs) of anticancer drugs. Misestimates in AE costs may significantly affect cost-effectiveness conclusions. Objective: To assess whether AE cost quantification in anticancer drug CEAs accurately reflects the true cost of AEs and to evaluate whether replacing AE costs with actual values affects cost-effectiveness conclusions. Evidence Review: A systematic search of PubMed, Web of Science, and Tufts CEA databases was conducted from October 24 to December 1, 2023, with an additional search from November 4 to 10, 2024, for English-language CEAs and claims-based studies examining AE costs for anticancer drugs published between January 2003 and December 2023. Claims-based AE costs were considered to represent actual values. AE costs were compared in absolute terms and as a proportion of total medical costs. Impact of replacing CEA AE cost estimates with actual values for incremental cost-effectiveness ratios (ICERs) was examined at thresholds of $100 000 and $150 000 per quality-adjusted life year (QALY). AE cost differences between CEA estimates and actual values and their impact on ICERs were the main outcomes. Findings: The sample included 11 claims-based US studies with 34 022 patients and 102 US payer-perspective CEAs. AE cost estimates in CEAs were consistently lower than actual values, with a median difference of 9.73% (IQR, 5.15%-27.22%; P = .002) in proportion of tota...