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

Hornberger, John; Reyes, Carolina; Shewade, Ashwini; Lerner, Susan; Friedmann, Mark; Han, Leona C.; Gutierrez, H; Satram‐Hoang, Sacha; Keating, Michael J.

doi:10.3109/10428194.2011.605918

Cited by 27 publications

(17 citation statements)

References 31 publications

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“…Saret et al evaluated the 29 studies listed in Table . They addressed the cost‐effectiveness of drugs approved between 1986 and 2006 (median year of Food and Drug Administration approval, 2001) in studies published between 1995 and 2012 (median year of publication, 2006).…”

Section: Reanalysis Of Cost‐effectiveness Studiesmentioning

confidence: 99%

Are high drug prices for hematologic malignancies justified? A critical analysis

Chhatwal

Mathisen

Kantarjian

2015

Cancer

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In the past 15 years, treatment outcomes for hematologic malignancies have improved substantially. However, drug prices have also increased drastically. This commentary examines the value of the treatment of hematologic malignancies at current prices in the United States through a reanalysis of a systematic review evaluating 29 studies of 9 treatments for 4 hematologic malignancies. Incremental cost‐effectiveness ratios (ICERs) were calculated on the basis of drug prices in the United States in 2014. Sixty‐three percent of the studies (15 of 24) had ICERs higher than $50,000 per quality‐adjusted life‐year (QALY), the benchmark widely used by health economists to define cost‐effectiveness. In studies evaluating the current standard‐of‐care treatments for chronic myeloid leukemia, the ICERs for tyrosine kinase inhibitors versus hydroxyurea or interferon ranged from $210,000 to $426,000/QALY. The lower ICER values were mostly obtained from 11 studies evaluating rituximab, which was approved by the Food and Drug Administration in 1997 (ICER range, $37,000‐$69,000/QALY). In conclusion, the costs of the majority of new treatments for hematologic cancers are too high to be deemed cost‐effective in the United States. Cancer 2015;121:3435–43. © 2015 American Cancer Society.

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Section: Reanalysis Of Cost‐effectiveness Studiesmentioning

confidence: 99%

Are high drug prices for hematologic malignancies justified? A critical analysis

Chhatwal

Mathisen

Kantarjian

2015

Cancer

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“…Two studies examined the cost effectiveness of rituximab for patients with chronic lymphocytic leukemia in the USA and Australia [29,30]. Although these studies conducted multiple economic evaluations with different comparators (single course of fludarabine plus cyclophosphamide or multiple courses of fludarabine plus The US study demonstrated that the cost-effectiveness results were robust to changes in any key input parameters and assumptions.…”

Section: Favorable Cost-effectiveness Resultsmentioning

confidence: 96%

“…Therefore, our review included 16 articles that evaluated nine mAb drugs for ten different orphan indications. Because several studies included more than one comparator or perspective in their economic evaluations, 24 economic evaluations were abstracted from 16 articles [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Table 2 presents an overview of the characteristics of the included economic studies.…”

Section: Quality Assessment Of the Studiesmentioning

confidence: 99%

Cost Effectiveness of Monoclonal Antibody Therapy for Rare Diseases: A Systematic Review

2015

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“…On the other hand, CUAs of hematological malignancies may warrant more standardization of their methodologies and incorporating more study sites. While we are quite concerned how experts would evaluate methodologies of conducting CUAs, we noted an improvement in the percentage of studies that appropriately report a calculated ICER [16] because reporting a calculated ICER is an established criterion that the CUA has been appropriately conducted. Moreover, a probabilistic sensitivity analysis has been more frequently reported in recent CUAs, again denoting an improvement in the quality of these studies.…”

Section: Discussionmentioning

confidence: 98%

“…In recent years, there have been a significant number of compounds approved for the treatment of these rare tumors. Those drugs impose a substantial financial burden in regards to the US and worldwide taxpayers [15,16]. Therefore, CUAs of novel therapies either in solid tumors or hematological malignancies are particularly important to delineate their additional cost and benefit.…”

Section: Discussionmentioning

confidence: 99%

Economic Evaluations of Hematological Malignancies Compared with Solid Tumors

Batty¹,

Shatzel²,

Wiles³

et al. 2014

J Leuk

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Introduction: Cancer care costs escalated with the introduction of novel therapies. Therefore, cancer-related Cost Utility Analyses (CUAs) are used to guide policy makers. Since numerous methods (criteria) exist to evaluate CUAs, we compared these criteria between CUAs of solid tumors and those of hematological malignancies. Methods:A systemic MEDLINE search of English-language publications between 2001 and 2012 was performed. Strict inclusion criteria were limited to CUAs examining one single intervention and one single study comparator. Standard data of 66 variables, based on the Drummond criteria, were collected to review each CUA for clarity, completeness, and health economic methodological quality.Results: Among 8,515 screened papers on Pubmed, 177 cancer-related CUAs (2%) were eligible. Solid tumors and hematological malignancies CUAs constituted 161(91%) and 16(9%). Among the standardized methods for evaluating CUAs, those of solid tumors reported more frequently the presentation of cost-effectiveness acceptability curve (p=0.02) and the use of threshold value to interpret study results (p=0.024) than those of hematological malignancies. Further, CUAs of solid tumors were more frequently multicenter-based (p=0.014); however, CUAs of hematological malignancies listed differential quality adjusted life year separately more frequently (p=0.02). Outcomes of CUAs of solid tumors were more frequently reported as significant (p=0.014). Conclusions:CUAs of solid tumors abided more frequently with the standardized methods (criteria) than those of hematological malignancies, which may be due in part to their multiple study sites. CUAs of hematological malignancies may warrant more methodological standardization and incorporate more study sites. MethodsA systemic MEDLINE search by the keywords: CUAs and cancer of English-language manuscripts published between 2001 and 2012 was performed. Eligibility criteria consisted of including only CUAs that examined one single intervention and one single study comparator. For example, adding rituximab to fludarabine and cyclophosphamide for the treatment of previously untreated chronic lymphocytic leukemia [15]. Exclusion criteria included CUAs that examined more than one intervention, more than one comparator or more than one study population or type of malignancy. The study population was not limited by age; therefore, CUAs examining children, adult or geriatric populations were included.

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

Cited by 27 publications

References 31 publications

Are high drug prices for hematologic malignancies justified? A critical analysis

Are high drug prices for hematologic malignancies justified? A critical analysis

Cost Effectiveness of Monoclonal Antibody Therapy for Rare Diseases: A Systematic Review

Economic Evaluations of Hematological Malignancies Compared with Solid Tumors

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