Cost-effectiveness of nintedanib versus pirfenidone in the treatment of idiopathic pulmonary fibrosis: a systematic review

INTRODUCTION: Objective: To systematically review studies on the cost-effectiveness of pirfenidone compared to nintedanib in patients with idiopathic pulmonary fibrosis (IPF). METHODS: Data sources: PubMed, EMBASE, Scopus, and Web of Science. Inclusion criteria: Full economic evaluations comparing pirfenidone versus nintedanib inIPF patients. Assessment: Quality of Health Economic Studies (QHES) tool forstudy quality. RESULTS: Nine studies met the inclusion criteria with QHES scores of 0.91 or higher. The incremental cost-effectiveness ratios (ICERs) ranged from $66,434 to $1,668,321 per quality-adjusted life year (QALY) in the United States. Nintedanib was found to be cost-effective in five studies. CONCLUSIONS: Nintedanib appears to be a more cost-effective treatment for IPF compared to pirfenidone. Further research is needed, particularly in low- and middle-income countries, considering healthcare system perspectives and varied willingness-to-pay thresholds. REGISTRATION: PROSPERO (CRD42024543954).