Cost-effectiveness of adding rituximab to fludarabine and cyclophosphamide for
the treatment of previously untreated chronic lymphocytic leukemia.
Author(s): Hornberger J, Reyes C, Shewade A, Lerner S, Friedmann M, Han L, Gutierrez H,
Satram-Hoang S, Keating MJ.
Affiliation(s): Cedar Associates LLC, Menlo Park, CA 94025, USA. jhornberger@cedarecon.com
Publication date & source: 2012, Leuk Lymphoma. , 53(2):225-34
A recent phase III trial demonstrated improved progression-free survival (PFS)
and overall survival (OS) associated with adding rituximab to fludarabine and
cyclophosphamide (R-FC) compared to FC in treatment of previously untreated
chronic lymphocytic leukemia (CLL). A cost-effectiveness analysis of R-FC over FC
was performed from a US third-party payer perspective over a lifetime horizon in
the base case. One-way, two-way and probabilistic sensitivity analyses were
conducted to assess the robustness of the results. A secondary analysis was
performed by also considering a societal perspective. R-FC was associated with an
incremental 1.15 quality-adjusted life-years (QALYs) compared to FC and resulted
in an incremental cost-effectiveness ratio of $23 530 per QALY in the base case
and $31 513 per QALY considering a societal perspective. Results were most
sensitive to time horizon, discount rate and unit drug cost for rituximab. Within
the limitations of modeling long-term outcomes, R-FC is cost-effective for
previously untreated CLL.
|