How are we evaluating the cost-effectiveness of companion biomarkers for targeted cancer therapies? A systematic review

TABLE 1 PICOS and Inclusion/Exclusion Criteria

PICOS	Inclusion criteria	Exclusion criteria
Population	Patients with cancer treated with biomarker-guided therapies.	Patients with cancer not treated with biomarker-guided therapies.
Intervention	Companion diagnostics. Biomarker-guided therapies. Precision medicine. Personalized medicine.	No companion diagnostics No predictive biomarkers for targeted therapies. No biomarker-guided therapies. Drugs without assessing companion biomarkers. Universal screening tools. Triage procedures. Severity or progression analyses.
Comparator	Unrestricted.	No comparative treatment. Surgery.
Outcome	Biomarker characteristics. Methodological approaches. Modeling inputs.	–
Study type	Full-text economic evaluations (cost-effectiveness analysis, cost-utility analysis).	Abstract. No economic evaluations. No English. Costing studies. Cost-minimization studies.

election of papers followed the eligibility criteria below:
Population: Patients with cancer tested with companion biomarker diagnostics for targeted therapies. Studies conducted on pre-specified patients with a particular biomarker status were excluded if they did not consider any of CDx-related characteristics in their evaluations
Intervention: companion biomarkers for targeted anti-cancer therapies. These biomarkers are used as diagnostic tools to guide the optimal treatment option(s) for patients responsive or unresponsive to the corresponding therapeutic products. Biomarker tests without market authorizations co-licensed with companion therapeutic products were not of interest in this review
Comparator: conventional treatments (e.g. chemotherapy, best supportive care) or targeted therapies with or without the use of companion biomarker tests
Outcome: Methodological or modelling approaches, biomarker characteristics, data inputs of biomarker tests. Studies without sufficient information reported on these items (e.g. abstracts) were excluded
Study type: economic evaluations including model or trial-based analyses

ISSN: 1471-2407