Introduction: With the advent of targeted therapy, the U.S. Food and Drug Administration has recently approved several oral anticancer medications (OAMs) for breast cancer (BC). Despite the improved effectiveness of those OAMs, the high financial burden is an issue. Evidence from cost-effectiveness analysis (CEA) can provide valuable information for decision-makers when deciding whether to use these high-priced medications. Many CEAs on OAMs have been conducted using various analytical approaches and cost-effectiveness thresholds (CETs). However, there is no comprehensive systematic review of CEAs across all OAMs.Area covered: PubMed and Cochrane library were used to select for CEAs of OAM for BC in the U.S. published by May 2019. Among the 25 included studies, studies published between 1993 and 2011 analyzed either early BC (n = 11) or advanced/metastatic BC (n = 5), those between 2012-2019 analyzed advanced/metastatic BC (n = 9). Studies including targeted therapies were published after 2009. The CETs tended to increase over time and were higher in the studies for advanced/metastatic BC (median = $125,000) than those for early BC (median = $50,000).Expert commentary: The target population and medications of interest have changed and the methods of articles have evolved. The range of CETs tends to differ by study setting with an increase over time.

中文翻译：

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在美国，乳腺癌的口服药物的经济评估：以成本效益阈值为重点的系统评价。

简介：随着靶向治疗的出现，美国食品药品监督管理局最近批准了几种针对乳腺癌（BC）的口服抗癌药物（OAM）。尽管这些OAM的有效性有所提高，但高昂的财务负担仍然是一个问题。成本效益分析（CEA）的证据可为决策者在决定是否使用这些高价药物时提供有价值的信息。已经使用各种分析方法和成本效益阈值（CET）对OAM进行了许多CEA。但是，并没有对所有OAM的CEA进行全面的系统性审查。研究范围：使用PubMed和Cochrane库选择2019年5月在美国发布的BC省OAM的CEA。在25项纳入研究中，1993年至2011年间发表的研究分析了早期BC（n = 11）或晚期/转移性BC（n = 5），2012-2019年间的研究则分析了晚期/转移性BC（n = 9）。2009年后发表了包括靶向疗法在内的研究。随着时间的推移，CET趋于增加，晚期/转移性BC的研究（中位数= $ 125,000）比早期BC的研究（中位数= $ 50,000）要高。专家评论：目标人群和感兴趣的药物已经改变，并且文章的方法已经发展。随着学习时间的推移，CET的范围往往会因学习设置而有所不同。随着时间的推移，CET趋于增加，在晚期/转移性BC研究中（中位数= $ 125,000）比早期BC（中位数= $ 50,000）中的CET更高。专家评论：目标人群和目标用药发生了变化，并且文章不断发展。随着学习时间的推移，CET的范围往往会因学习设置而有所不同。随着时间的推移，CET趋于增加，在晚期/转移性BC研究中（中位数= $ 125,000）比早期BC（中位数= $ 50,000）中的CET更高。专家评论：目标人群和目标用药发生了变化，并且文章不断发展。随着学习时间的推移，CET的范围往往会因学习设置而有所不同。