scholarly journals The clinical effectiveness and cost-effectiveness of bortezomib and thalidomide in combination regimens with an alkylating agent and a corticosteroid for the first-line treatment of multiple myeloma: a systematic review and economic evaluation.

2011 ◽  
Vol 15 (41) ◽  
Author(s):  
J Picot ◽  
K Cooper ◽  
J Bryant ◽  
AJ Clegg
Keyword(s):  
Systematic Review ◽  
Multiple Myeloma ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Alkylating Agent ◽  
Clinical Effectiveness ◽  
Line Treatment ◽  
First Line ◽  
Combination Regimens ◽  
First Line Treatment

scholarly journals Bortezomib-based therapy in non-transplant multiple myeloma patients: a retrospective cohort study from the FABIO project

2021 ◽  
Vol 12 ◽  
pp. 204062072199648
Author(s):  
Matteo Franchi ◽  
Claudia Vener ◽  
Donatella Garau ◽  
Ursula Kirchmayer ◽  
Mirko Di Martino ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Cohort Study ◽  
Cost Effectiveness ◽  
Line Treatment ◽  
First Line ◽  
Conventional Chemotherapy ◽  
Risk Of Death ◽  
Model Average ◽  
Italian Regions ◽  
First Line Treatment

Introduction: Randomized clinical trials showed that bortezomib, in addition to conventional chemotherapy, improves survival and disease progression in multiple myeloma (MM) patients not eligible for stem cell transplantation. The aim of this retrospective population-based cohort study is the evaluation of both clinical and economic profile of bortezomib-based versus conventional chemotherapy in daily clinical practice. Methods: Healthcare utilization databases of six Italian regions were used to identify adult patients with non-transplant MM, who started a first-line therapy with bortezomib-based or conventional chemotherapy. Patients were matched by propensity score and were followed from treatment start until death, lost to follow-up or study end-point. Overall survival (OS) and restricted mean survival time (RMST) were estimated using the Kaplan–Meier method. Association between first-line treatment and risk of death was estimated by a conditional Cox proportional regression model. Average mean cumulative costs were estimated and compared between groups. Results: In the period 2010–2016, 3509 non-transplant MM patients met the inclusion criteria, of which 1157 treated with bortezomib-based therapy were matched to 1826 treated with conventional chemotherapy. Median OS and RMST were 33.9 and 27.9 months, and 42.9 and 38.4 months, respectively, in the two treatment arms. Overall, these values corresponded to a HR of death of 0.79 (95% CI 0.71–0.89) over a time horizon of 84 months. Average cumulative cost were 83,839 € and 54,499 €, respectively, corresponding to an incremental cost-effectiveness ratio of 54,333 € per year of life gained, a cost coherent with the willingness-to-pay thresholds frequently adopted from Western countries. Conclusions: These data suggested that, in a large cohort of non-transplant MM patients treated outside the experimental setting, first-line treatment with bortezomib-based therapy was associated with a favourable effectiveness and cost-effectiveness profile.

scholarly journals Pembrolizumab (Keytruda)

2021 ◽  
Vol 1 (9) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Microsatellite Instability ◽  
Mismatch Repair ◽  
Drug Class ◽  
Clinical Effectiveness ◽  
Line Treatment ◽  
First Line ◽  
Clinician Perspectives ◽  
First Line Treatment

CADTH reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class. The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec. This review assesses pembrolizumab (Keytruda) 200 mg administered intravenously Indication: As monotherapy, for the first-line treatment of adults with metastatic microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) colorectal cancer

scholarly journals Cetuximab for the first-line treatment of metastatic colorectal cancer

2010 ◽  
Vol 14 (Suppl 1) ◽  
pp. 1-8
Author(s):  
C Meads ◽  
J Round ◽  
S Tubeuf ◽  
D Moore ◽  
M Pennant ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Liver Metastases ◽  
Metastatic Colorectal Cancer ◽  
Clinical Effectiveness ◽  
Economic Evaluations ◽  
Line Treatment ◽  
Wild Type ◽  
First Line ◽  
First Line Treatment

This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of cetuximab for the first-line treatment of metastatic colorectal cancer (mCRC), in accordance with the licensed indication, based upon the manufacturer’s submission to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal process. The ERG project ran between 22 January 2008 and 4 November 2008. The clinical evidence came from two unpublished randomised controlled trials (RCTs) of cetuximab plus chemotherapy versus chemotherapy alone in the first-line treatment of mCRC. A third RCT submitted later compared cetuximab with irinotecan in combination with 5-fluorouracil (5-FU) and folinic acid (FA) and cetuximab with oxaliplatin in combination with 5-FU and FA in patients with mCRC with liver metastases only. No published economic evaluations of cetuximab for first-line chemotherapy in mCRC were identified in the submission. A de novo model examined the cost-effectiveness of cetuximab in patients with mCRC that was epidermal growth factor receptor positive, k-ras wild type and with liver metastases. The main source of clinical effectiveness evidence came from the first two RCTs which provided follow up information for 1–2 years. Secondary information was used to estimate survival for a further 22 years. The model focused on the patients for whom the treatment had been licensed. This limited the applicability of the model to the NHS setting in which patients would be a mixture of k-ras wild type and mutations and also a mixture of patients with liver metastases and other metastases. The difference in progress-free survival for the two trials was between 0.5 to 1.2 months over a 7–10 month period. Eight months’ treatment with cetuximab, given as an initial loading dose and then weekly until progression, would cost around £22,932 for an average man and £18,427 for an average woman. It is uncertain whether this constitutes good value for money. The guidance issued by NICE on 25 September 2008 stated that cetuximab was not recommended for the first-line treatment of mCRC and people currently receiving cetuximab for the first-line treatment of mCRC should have the option to continue treatment until they and their clinicians consider it appropriate to stop.

Cost-effectiveness of high-dose chemotherapy in first-line treatment of advanced multiple myeloma

2001 ◽  
Vol 113 (4) ◽  
pp. 1015-1019 ◽  
Author(s):  
F. C. Sampson ◽  
S. M. Beard ◽  
F. Scott ◽  
E. Vandenberghe
Keyword(s):  
Multiple Myeloma ◽  
Cost Effectiveness ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

Cost-effectiveness analysis of pembrolizumab in cancer therapy: A systematic review.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 109-109
Author(s):  
Claudette Donatien ◽  
Lori-Ann Foster ◽  
F. Ellen Loh
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Cancer Therapy ◽  
Disease Progression ◽  
Line Treatment ◽  
First Line ◽  
Healthcare Budget ◽  
The Us ◽  
The Cost ◽  
First Line Treatment

109 Background: Cancer treatment is very costly and is further complexed by barriers to healthcare such as the lack of health insurance. Cancer detected at a later stage is more expensive to treat and the outcome can be less successful. Pembrolizumab is an immunotherapy that can be given alone or with chemotherapy. Pembrolizumab, a monoclonal antibody, may be considered first-line treatment in cancer therapy with its increase in life expectancy and successful treatment rates. Methods: A systematic review was conducted to identify relevant studies of the cost-effectiveness of Pembrolizumab treatment in cancer patients. We included studies that compared pembrolizumab to previous treatments, treatment-naive patients, advance melanoma, and metastatic non-small-cell lung cancer. Results: Most of the studies reviewed concluded that pembrolizumab was more cost-effective despite its high drug acquisition cost and disease management costs. Treatment with pembrolizumab was most effective when it was limited to 2 years, however, costs increased when treatment went beyond the two years and disease progression did not cease in most trials. In fact, disease progression occurred in many of the trials and patients had to discontinue treatment with pembrolizumab or other treatment regimens for several reasons not limited to adverse event. Regardless, pembrolizumab, if used as first-line treatment, would reduce the chances of disease progression or costs in drug therapy. Conclusions: Improving a patient’s quality of life is important when choosing the right course of treatment for any type of disease. In these studies, the quality-adjusted life years (QALY) were continuously increased when using pembrolizumab as compared to standard of care treatments and other immunotherapies. In the US healthcare system, the main factors to consider are the Healthcare Budget and the Payers willingness to pay. The US has legislated against the explicit use of cost per QALY thresholds but the $50,000 mark is commonly referred to. More studies should be conducted in the US to further conclude the cost-effectiveness of pembrolizumab in the treatment of cancer.

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