Keywords
Systematic review
cost - effectiveness
Pembrolizumab
cervical cancer
PD-L1.
Abstract
Objective: This systematic review evaluates methodological approaches, evidence quality, and outcomes of cost - effectiveness analyses for Pembrolizumab (Pem) in recurrent or metastatic cervical cancer.
Method: We systematically analysed cost - effectiveness analyses published between 2014 and 2024 from PubMed, ScienceDirect, Cochrane Library, and Google Scholar.
Results: Seven studies were selected. All included studies were conducted in the United States and China, with different model time horizons (5-50 years) and discount rates (3-5%). Comparator groups comprised: Atezolizumab + Bevacizumab + Chemotherapy; Bevacizumab + Chemotherapy; Pembrolizumab + Chemotherapy; Platinum-based Chemotherapy; and Placebo. Findings indicated that 57.1% of studies concluded Pembrolizumab was not cost - effective, 28.6% supported cost - effectiveness, and 14.3% were inconclusive.
Conclusion: Pembrolizumab improved clinical outcomes but demonstrated limited economic viability, with 57.1% of analyses deeming it non cost - effective due to high drug costs. Cost - effectiveness significantly improved in PD-L1 positive subgroups (CPS ≥ 1), supporting biomarker-guided personalized therapy.
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