Cost-effectiveness evaluation in cancer therapies, use of Markov models: An integrative literature review

Abstract

Objective: Review the scientific literature that addresses the cost-effectiveness of oncologic therapies, correlated with the limit of willingness to pay and quality of life (QALYs). Methods: A review was carried out through the search of publications in PUBMED, LILACS and EMBASE databases, in October 2018. The research strategy consisted of: terms for "cost effectiveness"; for "chemotherapy"; for "cancer"; and, associated with the term "markov model". Results: The research resulted in 209 publications, of which at the end, 18 articles composed this review. In most studies, the Markov model was focused on staging the disease, dividing it into three cycles, Progression Free State (PFS), Progressive Disease (PD) and Death. In the cost-effectiveness evaluations, few therapies presented improvements in the QALYS and a cost, and the comparisons that they obtained, form of therapies in which the standard drugs already presented a high cost, reducing the ICER of the innovative therapy. Conclusion: The results of the review showed a notable difficulty in justifying the insertion of new therapies through cost-effectiveness studies, as well as a great difference between the willingness to pay of the different countries, which directly influences the possibility of acquiring new treatments.