Articles Vol. 67 No. 10 31/10/2026

COST-EFFECTIVENESS ANALYSIS OF PEMBROLIZUMAB IN THE TREATMENT OF NON-SMALL CELL LUNG CANCER: A SYSTEMATIC REVIEW

Hoang Ha Cam Tu, Vu Thi Huong Tra, Phan Thi Hong Ngoc, Do Thi Ngoc Minh, Pham Huy Tuan Kiet
DOI: 10.52163/yhc.v67i10.6921
0 Views
0 Downloads
Abstract

Objective: This study aimed to synthesize the existing evidence on the cost-effectiveness of Pembrolizumab in the treatment of non-small cell lung cancer worldwide.

Methods: A systematic review was conducted following the PRISMA guidelines. Four international databases were systematically searched: PubMed, Dimensions, Cochrane Library, and HTA Database, up to December 2025. The reporting quality of included studies was assessed using the CHEERS 2022 checklist.

Results: A total of 29 studies were included in the review (all scoring > 21/28 on the CHEERS checklist). The findings showed that pembrolizumab was cost-effective in high-income countries at a willingness-to-pay (WTP) threshold of approximately 100,000 USD/QALY. In middle-income countries, pembrolizumab was generally not cost-effective unless patient assistance programs (PAP) were available or biosimilar versions were used.

Conclusion: Drug price is the key determinant of cost-effectiveness. The emergence of Pembroria, a biosimilar of Pembrolizumab with a price reduction of approximately 70%, presents a significant opportunity for its inclusion in Vietnam’s national health insurance reimbursement list.

Keywords
Pembrolizumab, cost-effectiveness, non-small cell lung cancer, systematic review.
References
[1]
[1] Viện Ung thư Quốc gia. Tình hình bệnh ung thư tại Việt Nam theo GLOBOCAN 2022, 2022. https://nci.vn/tin-tuc/tinh-hinh-benh-ung-thu-tai-viet-nam-theo-globocan-2022-58 Google Scholar
[2]
[2] Tian W, Niu L, Shi Y, Li S, Zhou R. First-line treatments for advanced non-squamous non-small cell lung cancer with immune checkpoint inhibitors plus chemotherapy: a systematic review, network meta-analysis, and cost-effectiveness analysis. Ther Adv Med Oncol, 2024, 16: 17588359241255613. doi: 10.1177/17588359241255613 Google Scholar
[3]
[3] Hiền Minh. Bộ Y tế cấp đăng ký lưu hành thuốc điều trị miễn dịch trong ung thư của Nga. Báo Điện tử Chính phủ. 11/11/2025. https://baochinhphu.vn/bo-y-te-cap-dang-ky-luu-hanh-thuoc-dieu-tri-dich-trong-ung-thu-cua-nga-102251111200337298.htm Google Scholar
[4]
[4] Page M.J et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 2021, 372: n71. doi: 10.1136/bmj.n71 Google Scholar
[5]
[5] Husereau D, Drummond M, Augustovski F, de Bekker-Grob E, Briggs A.H, Carswell C et al. Consolidated health economic evaluation reporting standards (CHEERS) 2022 explanation and elaboration: a report of the ISPOR CHEERS II good practices task force. Value Health, 2022, 25 (1): 10-31. doi: 10.1016/j.jval.2021.10.008 Google Scholar
[6]
[6] Bhadhuri A, Barbier M, Schiller M, Schwenkglenks M. Cost effectiveness of pembrolizumab vs chemotherapy as first-line treatment for metastatic NSCLC that expresses high levels of PD-L1 in Switzerland. Swiss Med Wkly, 2019, 149: w20170. doi: 10.4414/smw.2019.20170 Google Scholar
[7]
[7] Chouaid C, Bensimon L, Clay E, Millier A, Levy-Bachelot L, Huang M et al. Cost-effectiveness analysis of Pembrolizumab versus standard-of-care chemotherapy for first-line treatment of PD-L1 positive (> 50%) metastatic squamous and non-squamous non-small cell lung cancer in France. Lung Cancer, 2019, 127: 44-52. doi: 10.1016/j.lungcan.2018.11.008 Google Scholar
[8]
[8] Insinga R.P, Chandwani S, Liu Z, Wang X, Zhang Y. Cost-effectiveness of Pembrolizumab in advanced non-small cell lung cancer in the United States. J Med Econ, 2021, 24 (1): 1095-1104. doi: 10.1080/13696998.2021.1937188 Google Scholar
[9]
[9] Zhang X, Wang X, Wang J, Wang L, Li X, Zhang Y. Cost-effectiveness analysis of Pembrolizumab plus chemotherapy in squamous non-small-cell lung cancer in China. Risk Manag Healthc Policy, 2023, 16: 1849-1857. doi: 10.2147/RMHP.S429394 Google Scholar
[10]
[10] Mfumbilwa Z.A, Wilschut J.A, Groen H.J.M, Retèl V.P, van Harten W.H. Cost-effectiveness of Pembrolizumab monotherapy for high programmed death ligand 1 advanced or metastatic non-small cell lung cancer depends on long-term survivors. Pharmacoeconomics, 2025, 43 (8): 583-598. doi: 10.1007/s40261-025-01456-5 Google Scholar