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Table 3 Characteristics of the included studies

From: Cost-effectiveness of lung cancer screening and treatment methods: a systematic review of systematic reviews

Reference perspective Discounting Sensitivity analysis Incremental analysis Overall result
Clegg, Scott et al. 2001 [84] Social:3 Health:6 Payer:7 Not reported: 0 16 16 16 Vinorelbine has been reported to deliver cost savings or low incremental cost compared with best supportive care. Gemcitabine and paclitaxel have also led to small but acceptable incremental costs over BSC.
Lange, Prenzler et al. 2014 [85] Social:1 Health:7 Payer:11 Not reported: 0 17 12 17 First-line maintenance treatment with erlotinib compared to Best Supportive Care (BSC) can be considered cost-effective. In comparison to docetaxel, erlotinib is likely to be cost-effective in subsequent treatment regimens as well. The insights for bevacizumab are miscellaneous. There are findings that gefitinib is cost-effective in first- and second-line treatment
Bongers, Coupe et al. 2012 [86] Social: 0 Health:8 Payer:2 Not reported: 0 3 NS 8 In first-line treatment, gemcitabine + cisplatin was cost effective compared with other platinum-based regimens (paclitaxel, docetaxel and vinorelbine). In second-line treatment, docetaxel was cost effective compared with best supportive care; erlotinib was cost effective compared with placebo; and docetaxel and pemetrexed were dominated by erlotinib.
Raymakers, Mayo et al. 2016 [87] Social: 4 Health:1 Payer:5 Not reported:3 8 12 12 Results ranged from US$18,452 to US$66,480 per LYG and US$27,756 to US$243,077 per QALY gained for repeated screening. The cost-effectiveness of a lung cancer screening program using LDCT remains to be conclusively resolved. It is expected that its cost-effectiveness will largely depend on identifying an appropriate group of high risk subjects
Maher, Miake-Lye et al. 2012 [88] Social: 1 Health:4 Payer:17 Not reported:0 NS NS NS There are a large number of published cost-effectiveness analyses, but approximately two-thirds of such studies are supported by the makers of the drugs being assessed. Invariably, studies supported by the makers concluded that their drug was cost-effective. Of the cost-effectiveness analyses not supported by industry, the addition of bevacizumab to first-line therapy was found in one study to be not cost-effective, erlotinib was found in one study to be marginally cost-effective, and the differences between erlotinib and docetaxel maintenance therapy were slight in another study (GRADE = low).
Brown, Pilkington et al. 2013[89] Social: 1 Health:2 Payer:3 Not reported: 0 0 6 6 It is clear from the preceding sections that, although there exists published cost-effectiveness evidence comparing different first-line chemotherapy regimens for patients with NSCLC, very few studies are directly helpful to decision-makers, because the studies not estimate ICERs in terms of cost per QALY gained
Cao, Rodrigues et al. 2012 [90] Social: 0 Health:0 Payer:18 Not reported: 0 NS 18 18 The mean cost of PET was $1478. The cost-effectiveness metrics used in these studies were variable depending on sensitivity and specificity of diagnostic tests used in the models, probability of malignancy, and baseline strategy.
Black, Bagust et al. 2006 [58] Social: 1 Health:1 Payer:1 Not reported: 3 5 5 5 The magnitude of cost-effectiveness ratios reported very widely. All six made the fundamental assumption that screening with CT for lung cancer reduced mortality. At the current time, there is no evidence to support that assumption.
  1. NS not specified clearly