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Cost-effectiveness of dasatinib and nilotinib for imatinib-resistant or -intolerant chronic phase chronic myeloid leukemia.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Hoyle, Martin Rogers, Gabriel Moxham, Tiffany Liu, Zulian Stein, Ken |
| Copyright Year | 2011 |
| Abstract | OBJECTIVES To estimate the cost-effectiveness of dasatinib and nilotinib compared with high-dose imatinib for people with chronic phase chronic myeloid leukemia, which are resistant to normal-dose imatinib and compared with interferon-α for people intolerant to imatinib, from the perspective of the UK National Health Service. METHODS An an area under the curve partitioned survival model was developed to estimate the cost-effectiveness of dasatinib and nilotinib. Clinical effectiveness evidence was taken mostly from single-arm trials. RESULTS Both progression-free survival and overall survival are highly uncertain. In the base case, patients take nilotinib for much less time than dasatinib. Nilotinib is expected to dominate high-dose imatinib, yielding slightly more (0.32) quality-adjusted life years (QALYs) at slightly less cost (£11,100 [pound sterling]) per person. Dasatinib is predicted to provide slightly more (0.53) QALYs at substantially greater cost (£48,900), yielding a very high incremental cost-effectiveness ratio of £91,500 QALY against high-dose imatinib. Cost-effectiveness, however, changes radically under the plausible assumption that the drugs are taken for the same time. For people intolerant to imatinib, nilotinib is expected to yield an incremental cost-effectiveness ratio of £104,700/QALY, and dasatinib £82,600/QALY compared with interferon-α. Further, both drugs represent poor value for money for a range of plausible structural assumptions. CONCLUSIONS The model should be viewed as an exploratory analysis of the cost-effectiveness of dasatinib and nilotinib because it relies on many assumptions. Whilst clinical data remains immature, the cost-effectiveness of dasatinib and nilotinib for imatinib-resistant people is highly uncertain. Both nilotinib and dasatinib are highly unlikely to be cost-effective versus interferon-α for people intolerant to imatinib. |
| File Format | PDF HTM / HTML |
| DOI | 10.1016/j.jval.2011.07.006 |
| Alternate Webpage(s) | https://core.ac.uk/download/pdf/82529661.pdf |
| Alternate Webpage(s) | http://www.hvn.es/servicios_asistenciales/oncologia_radioterapica/ficheros/documentos/seminario_eeec_15062015/hoyle_et_al_paper_for_critical_appraisal.pdf |
| Alternate Webpage(s) | http://www.crd.york.ac.uk/crdweb/PrintPDF.php?AccessionNumber=22012000090&Copyright=NHS+Economic+Evaluation+Database+(NHS+EED)%3Cbr+/%3EProduced+by+the+Centre+for+Reviews+and+Dissemination+%3Cbr+/%3ECopyright+%26copy%3B+2018+University+of+York%3Cbr+/%3E |
| PubMed reference number | 22152175 |
| Alternate Webpage(s) | https://doi.org/10.1016/j.jval.2011.07.006 |
| Journal | Medline |
| Volume Number | 14 |
| Issue Number | 8 |
| Journal | Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
