Economic evaluations of sunitinib versus interferon-alfa (IFN-α) in first-line metastatic renal cell carcinoma (mRCC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6607-6607 ◽  
Author(s):  
E. Remák ◽  
C. D. Mullins ◽  
E. Akobundu ◽  
C. Charbonneau ◽  
K. Woodruff
Keyword(s):  
Cost Effectiveness ◽  
Survival Data ◽  
Phase Iii ◽  
Sensitivity Analyses ◽  
Economic Evaluations ◽  
Line Treatment ◽  
First Line ◽  
Physician Visits ◽  
Life Years ◽  
First Line Treatment

6607 Background: A randomized phase III trial of sunitinib vs. IFN-a as first-line therapy for patients with mRCC is ongoing. An interim analysis of this study demonstrated superiority for the primary endpoint, progression-free survival (PFS), in the sunitinib arm vs. the IFN-a arm (median PFS = 11 months [95% CI: 10–12] vs. 4 months [95% CI: 4–6]; P<0.000001). Because of the clinical significance of these results, the objective of this study was to demonstrate the economic value of sunitinib vs. IFN-a in this setting from a US third-party payer perspective. Methods: Two Markov models with a 5- and 10-year time horizon were developed to evaluate the cost- effectiveness of sunitinib vs. IFN-a. The models projected survival and costs in 6-week cycles based on extrapolation of the trial survival data. Model 1 looked at first-line treatment followed by palliative care only, while Model 2 incorporated second-line treatment. Effectiveness was measured in terms of progression-free months (PFM) in Model 1, and life-years (LY) gained and quality adjusted life-years (QALY) gained in Model 2. Resource utilization included drugs, tests, scans, monitoring, physician visits, hospitalizations and treatment of adverse events. Costs and survival benefits were discounted annually at 3% and 5% in Model 1 and 2, respectively. All costs were adjusted to 2006 US dollars. Scenario and probabilistic sensitivity analyses were conducted. Results: Projected PFS and overall survival were longer for sunitinib than for IFN-a. The incremental cost-effectiveness ratios of sunitinib vs. IFN-a over 5- and 10-years were $7,769 and $7,782/PFM, respectively, in Model 1. Model 2 results at 10 years were $67,215/LY and $52,593/QALY gained. The key drivers of the model results were survival and sunitinib drug costs. Both models were robust in the tested scenarios. Conclusions: Both analyses found that sunitinib is a cost-effective alternative to IFN-a as first-line treatment in mRCC, with cost-effectiveness ratios within the established threshold that society is willing to pay for health benefits (i.e. $50,000–100,000/LY or QALY). No significant financial relationships to disclose.

scholarly journals A Cost-Effectiveness Analysis of Systemic Therapy for Metastatic Hormone-Sensitive Prostate Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Winnie W. Y. Sung ◽  
Horace C. W. Choi ◽  
Peter H. Y. Luk ◽  
Tsz Him So
Keyword(s):  
Prostate Cancer ◽  
Cost Effectiveness ◽  
Lifetime Cost ◽  
Treatment Options ◽  
Sensitivity Analyses ◽  
Line Treatment ◽  
First Line ◽  
Life Years ◽  
Hormone Sensitive ◽  
First Line Treatment

BackgroundCurrently, approved first-line treatment options of metastatic hormone-sensitive prostate cancer (mHSPC) include (1) androgen deprivation therapy (ADT) alone, ADT plus one of the following: (2) docetaxel, (3) abiraterone, (4) enzalutamide, and (5) apalutamide. The high cost of novel androgen receptor pathway inhibitors warrants an understanding of the combinations’ value by considering both efficacy and cost.ObjectiveThis study aimed to compare the cost-effectiveness of these five treatment options in mHSPC from the US payer perspective to guide treatment sequence.MethodsA Markov model was developed to compare the lifetime cost and effectiveness of these five first-line treatment options for mHSPC using outcomes data from published literature. Health outcomes were measured in life-years and quality-adjusted life-years (QALYs). Drug costs were obtained from the Veterans Affairs Pharmaceutical Catalog. We extrapolated survival beyond closure of the trials.Outcome Measurements and Statistical AnalysisLife-years, QALYs, lifetime costs, and incremental cost-effectiveness ratios (ICERs) were estimated. Univariable, 2-way, and probabilistic sensitivity analyses were performed to evaluate parameter uncertainty. A willingness-to-pay (WTP) threshold of US$100,000 per QALY was used.ResultsCompared to ADT alone, docetaxel plus ADT provided a 0.28 QALY gain at an ICER of US$12,870 per QALY. Abiraterone plus ADT provided an additional 1.70 QALYs against docetaxel plus ADT, with an ICER of US$38,897 per QALY. Compared to abiraterone plus ADT, enzalutamide plus ADT provided an additional 0.87 QALYs at an ICER of US$509,813 per QALY. Apalutamide plus ADT was strongly dominated by enzalutamide plus ADT. Given the WTP threshold of US$100,000 per QALY, abiraterone plus ADT represented high-value health care.ConclusionsAbiraterone plus ADT is the preferred treatment option for men with mHSPC at a WTP threshold of US$100,000 per QALY.

Economic Evaluation of Sunitinib Malate for the First-Line Treatment of Metastatic Renal Cell Carcinoma

2008 ◽  
Vol 26 (24) ◽  
pp. 3995-4000 ◽  
Author(s):  
Edit Remák ◽  
Claudie Charbonneau ◽  
Sylvie Négrier ◽  
Sindy T. Kim ◽  
Robert J. Motzer
Keyword(s):  
Renal Cell Carcinoma ◽  
Cost Effectiveness ◽  
Cost Utility ◽  
Sensitivity Analyses ◽  
Line Treatment ◽  
First Line ◽  
Sunitinib Malate ◽  
Life Years ◽  
The Cost ◽  
First Line Treatment

Purpose To assess the cost effectiveness and cost utility of sunitinib malate as a first-line treatment in metastatic renal cell carcinoma (mRCC) compared with interferon-alfa (IFN-α) and interleukin-2 (IL-2) from a US societal perspective. Methods A Markov model was developed to simulate disease progression and to determine progression-free survival, total life-years (LYs), and quality-adjusted life-years (QALYs) gained. Model parameters were derived from the pivotal trial of sunitinib, published literature, government sources, and clinical experts’ opinions. The model included trial-based adverse events (AEs). Costs of drug treatment, routine follow-up, AEs, disease progression, and best supportive care (BSC) of terminally ill patients were included. Results were tested using probabilistic and deterministic sensitivity analyses. Results Treatment with sunitinib is associated with a gain in progression-free years of 0.41 and 0.35 over IFN-α and IL-2. The estimated gains over IFN-α were 0.11 LYs and 0.14 QALYs, and over IL-2 were 0.24 LYs and 0.20 QALYs. Both IFN-α and sunitinib treatments dominate IL-2 treatment; the incremental cost-effectiveness ratio of sunitinib versus IFN-α was $18,611 per progression-free year gained and $67,215 per LY gained, and the cost-utility ratio is $52,593 per QALY gained (at a 5% discount rate). Sensitivity analyses found the results to be most sensitive to utility values during treatment, the cost of sunitinib, and the cost of BSC. Model results were robust to changes in other model variables. Conclusion These results suggest that sunitinib is a cost-effective alternative to IFN-α as a first-line treatment for mRCC.

scholarly journals Cost-effectiveness analysis of cetuximab combined with chemotherapy as a first-line treatment for patients with RAS wild-type metastatic colorectal cancer based on the TAILOR trial

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e030738 ◽  
Author(s):  
Huijuan Wang ◽  
Lingfei Huang ◽  
Peng Gao ◽  
Zhengyi Zhu ◽  
Weifeng Ye ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Metastatic Colorectal Cancer ◽  
Survival Benefit ◽  
Cost Effective ◽  
Phase Iii ◽  
Line Treatment ◽  
Wild Type ◽  
First Line ◽  
First Line Treatment

ObjectivesCetuximab plus leucovorin, fluorouracil and oxaliplatin (FOLFOX-4) is superior to FOLFOX-4 alone as a first-line treatment for patients with metastatic colorectal cancer with RAS wild-type (RAS wt mCRC), with significantly improved survival benefit by TAILOR, an open-label, randomised, multicentre, phase III trial. Nevertheless, the cost-effectiveness of these two regimens remains uncertain. The following study aims to determine whether cetuximab combined with FOLFOX-4 is a cost-effective regimen for patients with specific RAS wt mCRC in China.DesignA cost-effectiveness model combined decision tree and Markov model was built to simulate pateints with RAS wt mCRC based on health states of dead, progressive and stable. The health outcomes from the TAILOR trial and utilities from published data were used respectively. Costs were calculated with reference to the Chinese societal perspective. The robustness of the results was evaluated by univariate and probabilistic sensitivity analyses.ParticipantsThe included patients were newly diagnosed Chinese patients with fully RAS wt mCRC.InterventionsFirst-line treatment with either cetuximab plus FOLFOX-4 or FOLFOX-4.Main outcome measuresThe primary outcomes are costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs).ResultsBaseline analysis disclosed that the QALYs was increased by 0.383 caused by additional cetuximab, while an increase of US$62 947 was observed in relation to FOLFOX-4 chemotherapy. The ICER was US$164 044 per QALY, which exceeded the willingness-to-pay threshold of US$28 106 per QALY.ConclusionsDespite the survival benefit, cetuximab combined with FOLFOX-4 is not a cost-effective treatment for the first-line regime of patients with RAS wt mCRC in China.Trial registration numberTAILOR trial (NCT01228734); Post-results.

Cost-effectiveness of rituximab plus CVP for first-line treatment of advanced indolent lymphoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6583-6583
Author(s):  
J. Hornberger ◽  
C. Reyes ◽  
E. Verhulst ◽  
D. Lubeck ◽  
N. Valente
Keyword(s):  
Overall Survival ◽  
Cost Effectiveness ◽  
Follicular Lymphoma ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Line Treatment ◽  
First Line ◽  
Economic Implications ◽  
The Cost ◽  
First Line Treatment

6583 Background: The addition of rituximab (RTX) to CVP (cyclophosphamide, vincristine, prednisone) in the treatment of advanced follicular lymphoma increases median time to progression by 17 months (15 month v 32 months; p < 0.0001) (Marcus et al, Blood 2005). A societal cost-effectiveness analysis was performed to estimate projected lifetime clinical and economic implications of this treatment. Methods: The cost-effectiveness (CE) of RTX + CVP versus CVP was estimated for a 50 yr old patient. Kaplan-Meier estimates of progression-free and overall survival, up to 4 years, were obtained from the M39021 trial. After 4 years, transition rates from initiation of treatment to progression or death were assumed to be the same in both arms. The clinical and economic implications of relapse and its treatment were included in the model. Incremental costs associated with addition of RTX were estimated using Medicare reimbursement rates and published retail price data. Costs included drug and administration costs, adverse events, treatment of relapses, and end-of-life costs. Utility estimates were derived from the literature and a 3% discount rate was employed. Results: Projected mean overall survival is 1.5 yrs longer for patients assigned to RTX+ CVP versus only CVP (13.7 v 12.2 yrs). The addition of RTX to CVP is estimated to cost an additional $26,439 on average, with an expected gain of 0.85 year of quality-adjusted survival. Over a lifetime, the cost per QALY gained is $31,329. Sensitivity analyses revealed that the variables that most influenced cost-effectiveness were the time horizon (range: $18,800- $31,240) and the unit drug cost of RTX (range: $24,000-$38,000). Conclusion: The model estimates a cost-to-QALY gained ratio that is below that of many treatments used for oncology patients. The use of RTX + CVP for first-line treatment of advanced follicular lymphoma is projected to be cost-effective compared to CVP alone under a range of sensitivity analyses. No significant financial relationships to disclose.

Cost-effectiveness evaluation of abiraterone in the treatment of patients with castration-resistant prostate cancer who previously received docetaxel.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15107-e15107
Author(s):  
Akhil Chopra ◽  
Stefan Gluck ◽  
Alberto J. Montero ◽  
Kiran Kumar Venkata Raja Avancha ◽  
Gilberto Lopes
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Survival Data ◽  
Drug Acquisition ◽  
Phase Iii ◽  
Sensitivity Analyses ◽  
Life Years ◽  
The Us

e15107 Background: Treatment with abiraterone improves overall survival (OS), time to prostate-specific antigen progression and radiologic progression-free survival when added to prednisone and best supportive care in patients with advanced castrate-resistant prostate cancer (CRPC) who previously received docetaxel. Little is known about its cost-effectiveness in the United States. Methods: In order to raise awareness of pharmacoeconomics concepts and inform policy-makers in the US, this study aimed to assess the cost-effectiveness of abiraterone in the treatment of advanced CRPC patients, from a payer perspective. We created a decision-analytical model using clinical data from the pivotal phase III trial: COU-AA-301. Health utilities were derived from the available literature. Costs for drug acquisition, physician visits and laboratory tests were obtained from the Center for Medicare Services Drug Payment Table and Physician Fee Schedule and are represented in 2011 US dollars. Life-years saved (LY), Quality-adjusted life years (QALY) and Incremental Cost Effectiveness Ratio (ICER) were calculated using updated survival data presented at the 2011 ASCO meeting. Other main scenarios used the original median survival data published in the New England Journal of Medicine article and adjusted median OS to represent an overall survival hazard ratio of .66. Sensitivity analyses were performed using the confidence intervals for median OS in the pivotal study as well as by halving or doubling all other model inputs. No discounting was used due to the short time-horizon. Results: Abiraterone added 0.38 LY and 0.30 QALY with an incremental cost of $39,320 and therefore a cost of $102,600/LY and an ICER of $129,000/QALY. The main drivers of the model were drug acquisition cost, median OS, and health utility values. The results of the model were robust in different scenarios and sensitivity analyses. Conclusions: Using commonly accepted willingness-to-pay thresholds, such as those suggested by the World Health Organization, treatment of patients with advanced CRPC patients with abiraterone is likely to be cost-effective in the US.

scholarly journals Cost-Effectiveness Analysis of Atezolizumab Versus Chemotherapy as First-Line Treatment for Metastatic Non-Small-Cell Lung Cancer With Different PD-L1 Expression Status

2021 ◽  
Vol 11 ◽  
Author(s):  
Guoqiang Liu ◽  
Shuo Kang ◽  
Xinchen Wang ◽  
Fangjian Shang
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Line Treatment ◽  
Wild Type ◽  
First Line ◽  
Metastatic Nsclc ◽  
The Cost ◽  
Expression Status ◽  
First Line Treatment

BackgroundAtezolizumab could significantly improve clinical outcomes and was associated with less toxicity compared with chemotherapy as the first-line treatment of PD-L1-selected patients with EGFR and ALK wild-type metastatic non-small-cell lung cancer (NSCLC). However, the economic outcomes remain unclear yet in China. This study aimed to investigate the cost-effectiveness of atezolizumab versus chemotherapy as first-line therapy for metastatic NSCLC with different PD-L1 expression status from the Chinese health sector perspective.MethodsA decision-analytic model was conducted to evaluate the economic outcomes for the first-line treatment of EGFR and ALK wild-type metastatic NSCLC with atezolizumab and chemotherapy in high PD-L1 expression, high or intermediate PD-L1 expression and any PD-L1 expression populations, respectively. The efficacy and safety data were obtained from the IMpower110 trial. Cost and utility values were gathered from the local charges and published literatures. Incremental cost-effectiveness ratio (ICER) was estimated. A scenario analysis for a patient assistance program (PAP) was conducted. One-way and probabilistic sensitivity analyses were performed to explore the robustness of the model results.ResultsAtezolizumab yielded additional 0.91 QALYs, 0.57 QALYs, 0.42 QALYs in comparison with chemotherapy, and the ICERs were $123,778.60/QALY, $142,827.19/QALY, $168,902.66/QALY in the high PD-L1 expression, high or intermediate PD-L1 expression, and any PD-L1 expression populations, respectively. When PAP was available, the ICERs were $52,414.63/QALY, $52,329.73/QALY, $61,189.66/QALY in the three categories of PD-L1 expression status populations, respectively. The ICERs were exceed the willingness-to-pay (WTP) threshold of $30,828/QALY (three times of per capita gross domestic product of China in 2019) in China. One-way sensitivity analyses suggested that the cost of atezolizumab played a vital role in the model outcomes, and the probabilistic sensitivity analyses showed atezolizumab was unlikely to be cost-effective at the WTP threshold regardless of PD-L1 expression status and whether the PAP was available or not.ConclusionsAtezolizumab as first-line treatment for PD-L1-selected metastatic NSCLC patients without EGFR mutations or ALK translocations is unlikely to be cost-effective compared with chemotherapy regardless of PD-L1 expression status in the Chinese context.

scholarly journals The Cost-Effectiveness of Lenvatinib in the Treatment of Advanced or Unresectable Hepatocellular Carcinoma from a Canadian Perspective

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Brandon M. Meyers ◽  
Arndt Vogel ◽  
Paul Marotta ◽  
Petr Kavan ◽  
Laveena Kamboj ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Cost Effectiveness ◽  
Phase Iii ◽  
Line Treatment ◽  
First Line ◽  
Unresectable Hepatocellular Carcinoma ◽  
Canadian Perspective ◽  
The Cost ◽  
First Line Treatment

Lenvatinib is an oral multikinase inhibitor indicated for the first-line treatment of unresectable hepatocellular carcinoma (uHCC). In the Phase III REFLECT trial, lenvatinib was noninferior in the primary endpoint of overall survival versus sorafenib, the only systemic therapy funded in Canada prior to the introduction of lenvatinib. Lenvatinib also demonstrated statistically significant improvement compared to sorafenib in secondary endpoint progression-free survival, time to progression, and objective response rate. The aim of this analysis was to estimate the cost-effectiveness of lenvatinib versus sorafenib for the first-line treatment of patients with uHCC from a Canadian perspective. A cost-utility analysis was conducted using partitioned survival modelling, with health states representing progression-free disease, progressed disease, and death. Health effects were measured using quality-adjusted life years (QALYs), and costs were represented in Canadian dollars. Clinical inputs were derived from the REFLECT trial, with outcomes extrapolated using parametric survival models. EQ-5D data collected in REFLECT were used to determine health state utility values, and estimates of resource use came from a survey of clinicians. The model predicted incremental costs of-$5,021 and incremental QALYs of 0.17, making lenvatinib dominant over sorafenib. The model demonstrates lenvatinib to be a cost-effective use of resources versus sorafenib in Canada for the treatment of uHCC. Overall costs are lower compared with sorafenib, while health benefits are greater, with modelled progression-free and overall survival extended by 4.1 and 2.6 months in the lenvatinib arm, respectively.

The cost effectiveness of lenvatinib versus atezolizumab and bevacizumab or sorafenib in patients with unresectable hepatocellular carcinoma (uHCC) in Canada.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 4098-4098
Author(s):  
David Trueman ◽  
Yifeng Liu ◽  
Marc Geadah ◽  
Nicholas Hon ◽  
Suthakar Sabapathy ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cost Effectiveness ◽  
Phase Iii ◽  
Base Case ◽  
Health State ◽  
Line Treatment ◽  
Relative Efficacy ◽  
First Line ◽  
The Cost ◽  
First Line Treatment

4098 Background: Hepatocellular carcinoma (HCC) represents 72% of liver cancers in Canada. In the phase III REFLECT trial, lenvatinib met the primary endpoint of non-inferiority in overall survival (OS) versus sorafenib and demonstrated superiority in secondary endpoints of progression free-survival (PFS), time to progression and objective response rate. Based on the REFLECT trial, lenvatinib has become the standard of care in the treatment of Canadian patients with unresectable HCC (uHCC). In the Phase III IMbrave150 trial, the use of the combination of atezolizumab and bevacizumab (atezo+bev) resulted in statistically significant improvement in OS and PFS versus sorafenib for patients with uHCC. The aim of this analysis was to estimate the cost-effectiveness of lenvatinib versus atezo+bev or sorafenib as first-line treatment for patients with uHCC from the perspective of Ministry of Health in Canada. Methods: A cost-utility analysis was conducted using a partitioned survival analysis. Health state membership for lenvatinib and sorafenib were estimated based on patient level data and clinical inputs from REFLECT and extrapolated using parametric survival models. Relative efficacy for atezo+bev was estimated from a de novo network meta-analysis. In the base-case analysis, estimates from REFLECT used in the NMA were adjusted for imbalances in baseline characteristics. Sensitivity analyses included the use of alternative approaches to determine relative efficacy. Health state utility values were determined with EQ-5D data collected in REFLECT. Drug acquisition costs were obtained from publicly available sources and medical resource utilization was based on a survey of Canadian clinicians. The time horizon was 10 years. Results of the incremental analysis were calculated sequentially. Results: In the base case lenvatinib was associated with cost savings of CAD$4,640 and CAD$120,095 and a QALY difference of 0.15 and -0.28 vs sorafenib and atezo+bev, respectively. The base case deterministic analysis resulted in lenvatinib being dominant over sorafenib and cost-effective vs. atezo+bev (sequential ICER for atezo+bev was CAD$425,754 per QALY). Results of the probabilistic sensitivity analysis (PSA) were consistent with the base case findings with lenvatinib being the optimal treatment strategy in >99% of iterations. Conclusions: Results of this analysis demonstrate that lenvatinib represents the optimal use of healthcare resources as a first-line treatment for uHCC in Canada.

Cost-Effectiveness of Imatinib in Comparison with Bone Marrow Transplant in Chronic Phase (CP) Chronic Myeloid Leukaemia (CML) in China.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2474-2474
Author(s):  
Zhixiang Shen ◽  
Xiaojun Huang ◽  
Samara Mendes de Costa ◽  
Zi Chen ◽  
Xiaoping Xu ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Overall Survival ◽  
Cost Effectiveness ◽  
Chinese Population ◽  
Line Treatment ◽  
Survival Curves ◽  
First Line ◽  
Life Years ◽  
The Cost ◽  
First Line Treatment

Abstract Abstract 2474 Poster Board II-451 Background Imatinib is associated with significant long-term survival benefits in CP CML patients versus bone marrow transplantation (BMT). Despite the proven benefits of imatinib and its position in first line treatment of chronic CML in several countries, BMT remains a treatment option in first line treatment of CML China. This modelling study was designed to explore the cost-effectiveness of imatinib in the Chinese setting. Methods A model was built in Microsoft Excel, with quarterly time intervals for overall survival over a 2-year period due to the lack of longer term follow up cost data for BMT. Published survival curves for the Chinese population were not available for either imatinib or BMT; however survival data for both imatinib and BMT from previous published literature were found to be broadly consistent with those reported in an unpublished survival meta-analysis of imatinib and BMT in Chinese population. The overall survival curve for imatinib sourced from the IRIS study (Druker et al 2006) was reconstructed in order to populate the imatinib arm of the model, and transplantation survival curves from Hasford et al (ASH 2008) were used to populate the BMT arm in the model. It was assumed that all patients surviving in each cycle remained in remission. Costs were based on the Chinese payment system. Due to the lack of publicly available cost data in China, a retrospective analysis of patient billings was conducted in 3 top tier hospitals in China (2 in Shanghai and 1 in Beijing) using a paper-based data collection questionnaire, with a target of 60 patients in total. Costs included in the model were: average cost of transplantation (including pre-operative and post-operative care and the transplantation procedure, as well as donor costs), complications associated with BMT and imatinib, quarterly cost of imatinib to the patients, and average quarterly charges for tests and monitoring. Utilities used in the model were sourced from IRIS; the utility for imatinib patients in remission was 0.854. Due to lack of published utility values in BMT patients, it was assumed that transplantation patients in remission would experience the same utility as interferon plus low-dose cytarabine (0.71). The outcomes of the model were total costs of treatment, life years, quality adjusted life years (QALY). A discount rate of 5% was used for costs and 0% for outcomes (utilities and life-years). Results Based on a cohort of 500 patients in each arm, the use of imatinib in CP CML yielded 497 and 971 life years (424 and 829 QALYs) at 1 and 2 years for imatinib vs. 485 and 898 for BMT (345 and 637 QALYs). Incremental life years (QALYs) were 12 (80) and 73 (192) at 1 and 2 years comparing imatinib with BMT. Total costs for imatinib were 73,194,400 RMB and 143,380,400 RMB at 1 and 2 years vs. 134,789,745 RMB and 143,552,071 RMB for BMT. Therefore, the cost savings for imatinib vs. BMT were 61,595,345 RMB and 171,671 RMB at 1 and 2 years. Imatinib is a dominant strategy to BMT (i.e., lower cost and higher efficacy) at 1 and 2 years. The model results were most sensitive to varying costs of BMT and discounting rates. Conclusion The results of the model demonstrate that imatinib is associated with improved overall survival and lower costs compared with BMT for the first 2 years in treating CP CML patients in the Chinese setting. Imatinib should be the first line treatment in CP CML based on both clinical and economic evidence. Disclosures: No relevant conflicts of interest to declare.

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