Medicamenteuze behandeling van chronische myeloïde leukemie: een kosteneffectiviteitsanalyse van 1e- en 2e-lijnsbehandeling

To determine the average cost-effectiveness ratio of treatment of patients with chronic myeloid leukaemia (CML): with first-line interferon alpha-2a (IFN) or with second-line imatinib following IFN failure.

Design

Cost-effectiveness analysis.

Method

A general cost-effectiveness analysis was performed using a model. This model consists of two phases: an induction phase of eight months, in which newly-diagnosed patients are treated with either IFN or imatinib, and a chronic treatment phase wherein patients are treated according the result of the induction phase. The model calculated the costs and effects of the treatment. Input for this model was derived from literature and expert opinion. Costs were based on real cost prices and tariffs.

Results

Treatment with imatinib resulted in 6.67 quality-adjusted life years (QALYs) and treatment with IFN resulted in 4.98 QALYs. Average costs of treatment with 5 million IU/day of IFN were € 76,969 and € 53,257 with 3 million IU/day. For imatinib at 400 mg/day the costs were € 140,765 per patient. Costs per QALY were € 15,445, € 10,687 and € 21,082, respectively.

Conclusion

The addition of imatinib to the treatment options in CML resulted in increased quality-adjusted survival, but also higher costs of treatment.