Immune-checkpoint inhibitors (ICIs) are transforming oncology, but the mounting costs of cancer care necessitate concerns regarding economic sustainability. Here, several strategies that clinicians could use to exercise economically prudent administration of ICIs are discussed. These include better appraisal of the cost-effectiveness literature, judicious patient selection, separating statistical from clinical significance, and careful patient counselling.
This is a preview of subscription content, access via your institution
Relevant articles
Open Access articles citing this article.
-
Unleashing T cell anti-tumor immunity: new potential for 5-Nonloxytryptamine as an agent mediating MHC-I upregulation in tumors
Molecular Cancer Open Access 15 August 2023
-
A systematic review of the cost and cost-effectiveness studies of immune checkpoint inhibitors
Journal for ImmunoTherapy of Cancer Open Access 23 November 2018
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Mariotto, A. B. et al. Projections of the cost of cancer care in the United States: 2010–2020. J. Natl Cancer Inst. 103, 117–128 (2011).
McCrea, C. et al. Cost-effectiveness of nivolumab in patients with advanced renal cell carcinoma treated in the United States. Exp. Hematol. Oncol. 7, 4 (2018).
Ferris, R. L. et al. Nivolumab for recurrent squamous-cell carcinoma of the head and neck. N. Engl. J. Med. 375, 1856–1867 (2016).
Tringale, K. R. et al. Cost-effectiveness analysis of nivolumab for treatment of platinum-resistant recurrent or metastatic squamous cell carcinoma of the head and neck. J. Natl Cancer Inst. 110, 479–485 (2018).
Reck, M. et al. Pembrolizumab versus chemotherapy for PD-L1–positive non–small-cell lung cancer. N. Engl. J. Med. 375, 1823–1833 (2016).
Carbone, D. P. et al. First-line nivolumab in stage IV or recurrent non-small-cell lung cancer. N. Engl. J. Med. 376, 2415–2426 (2017).
Huang, M. et al. Cost-effectiveness of pembrolizumab versus docetaxel for the treatment of previously treated PD-L1 positive advanced NSCLC patients in the United States. J. Med. Econ. 20, 140–150 (2017).
Matter-Walstra, K. et al. A cost-effectiveness analysis of nivolumab versus docetaxel for advanced nonsquamous NSCLC including PD-L1 testing. J. Thorac. Oncol. 11, 1846–1855 (2016).
Aguiar, P. N. Jr. et al. The effect of PD-L1 testing on the cost-effectiveness and economic impact of immune checkpoint inhibitors for the second-line treatment of NSCLC. Ann. Oncol. 28, 2256–2263 (2017).
Lopes, G. et al. Pembrolizumab (pembro) versus platinum-based chemotherapy (chemo) as first-line therapy for advanced/metastatic NSCLC with a PD-L1 tumor proportion score (TPS) ≥1%: open-label, phase 3 KEYNOTE-042 study. J. Clin. Oncol. 36 (Suppl.), Abstr. LBA4 (2018).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The author declares no competing interests.
Rights and permissions
About this article
Cite this article
Verma, V. Economic sustainability of immune-checkpoint inhibitors: the looming threat. Nat Rev Clin Oncol 15, 721–722 (2018). https://doi.org/10.1038/s41571-018-0086-z
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41571-018-0086-z
This article is cited by
-
Unleashing T cell anti-tumor immunity: new potential for 5-Nonloxytryptamine as an agent mediating MHC-I upregulation in tumors
Molecular Cancer (2023)
-
Emerging evidence for adapting radiotherapy to immunotherapy
Nature Reviews Clinical Oncology (2023)
-
A systematic review of the cost and cost-effectiveness studies of immune checkpoint inhibitors
Journal for ImmunoTherapy of Cancer (2018)
