Sarcouncil Journal of Medical Sciences

Abstract: Objectives: Advanced drug-delivery platforms (DDPs) represent a new generation of therapeutic technologies designed to optimize pharmacokinetics, enhance adherence, and improve health outcomes in chronic and high-burden diseases. This study aimed to identify, synthesize, and critically appraise published economic evaluations of advanced DDPs within U.S. disease contexts, focusing on cost-effectiveness, cost-utility, and budget-impact analyses. Methods: A systematic review was conducted using 33 peer-reviewed publications evaluating the economic performance of DDPs, including nanocarriers, microneedles, and implantable pumps, long-acting injectable and AI-enabled systems. Studies were assessed for design, data sources, costing methodology, modeling approach, and sensitivity analyses. All monetary results were standardized to 2025 U.S. dollars for comparability. Results: Across disease areas, including oncology, neurology, diabetes, cardiovascular and infectious diseases. 83% of studies found DDPs to be cost-effective under U.S. willingness-to-pay thresholds ($100,000-$150,000 per QALY). Microneedle and AI-driven platforms demonstrated the highest economic value, with mean ICERs of $46,000-$61,000/QALY, while nanocarriers averaged $78,000/QALY. Several studies reported DDPs as dominant strategies that are responsible for improving outcomes at reduced cost. Conclusions: Advanced DDPs consistently exhibit favorable cost-effectiveness across major U.S. therapeutic areas. Future evaluations should integrate real-world evidence, long-term adherence modeling, and payer-aligned quality-of-life metrics. As healthcare shifts toward value-based reimbursement, these platforms offer a sustainable pathway to achieving both clinical and economic efficiency in modern pharmacotherapy.