Cost-effectiveness of adding rituximab to fludarabine and cyclophosphamide for the treatment of previously untreated chronic lymphocytic leukemia

Abstract 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 a...

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Bibliographic Details
Published in:Leukemia & lymphoma 2012-02, Vol.53 (2), p.225-234
Main Authors: Hornberger, John, Reyes, Carolina, Shewade, Ashwini, Lerner, Susan, Friedmann, Mark, Han, Leona, Gutierrez, Hialy, Satram-Hoang, Sacha, Keating, Michael J.
Format: Article
Language:English
Subjects:
Antibodies, Monoclonal, Murine-Derived - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - economics
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
chronic lymphocytic leukemia
Cost-Benefit Analysis
Cost-effectiveness
cyclophosphamide
Cyclophosphamide - administration & dosage
Female
fludarabine
Follow-Up Studies
Humans
Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy
Leukemia, Lymphocytic, Chronic, B-Cell - economics
Leukemia, Lymphocytic, Chronic, B-Cell - mortality
Male
Middle Aged
previously untreated
Prognosis
Quality-Adjusted Life Years
Rituximab
Survival Rate
Vidarabine - administration & dosage
Vidarabine - analogs & derivatives
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Summary:Abstract 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.
ISSN:1042-8194
1029-2403
DOI:10.3109/10428194.2011.605918