ClinicoEconomics and Outcomes Research (Apr 2021)
Cost-Effectiveness Analysis of Gemtuzumab Ozogamicin for First-Line Treatment of Patients with Cd-33 Positive Acute Myeloid Leukaemia in Spain
Abstract
Maria Mareque,1 Pau Montesinos,2 Patricia Font,3 José María Guinea,4 Adolfo de la Fuente,5 Javier Soto,6 Itziar Oyagüez,1 James Brockbank,7 Tamara Iglesias,6 Julia Llinares,6 Jorge Sierra8 1Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid, Spain; 2Hospital Universitario La Fe, Valencia, Spain; 3Hospital General Universitario Gregorio Marañón, Madrid, Spain; 4Organización Sanitaria Integrada Araba, País Vasco, Spain; 5Hospital MD Anderson, Madrid, Spain; 6Pfizer, Madrid, Spain; 7RTI Health Solutions, Manchester, UK; 8Hospital Universitario de La Santa Creu i Sant Pau, Barcelona, SpainCorrespondence: Maria MarequePharmacoeconomics & Outcomes Research Iberia (PORIB), Paseo Joaquín Rodrigo 4-I, Pozuelo de Alarcón, Madrid, 28224, SpainTel + 34 91 715 91 47Fax + 34 91 715 94 69Email [email protected]: To assess the incremental cost–utility ratio (ICUR) of gemtuzumab ozogamicin (GO) + standard of care (SOC) vs SOC alone for treatment of patients with de novo AML from a Spanish Health Service perspective.Methods: A cohort state-transition model, with 12 health-states, was used to estimate the lifetime accumulated cost and benefits in terms of quality-adjusted-life-years (QALYs) in AML patients with favourable, intermediate, and unknown cytogenetic profiles. Patient profile was defined based on the ALFA-0701 trial. Therapeutic regimens were defined by 5 haematologists. SOC was assumed to be idarubicin and cytarabine, the combination most used in Spain. QALYs were estimated by applying utilities for the time spent by the cohort in each health-state and utility decrements associated with adverse events (AE). Total cost (€,2020) included drug-acquisition, hematologic stem-cell transplantation, disease management, AE management and end-of-life costs. Unit costs were derived from local databases. All parameters were validated by haematologist. Costs and outcomes were discounted (3%/year).Results: Higher cost/patient (€ 177,618 vs € 151,434) and greater QALYs (5,70 vs 4,62) were obtained with GO+SOC vs SOC. The ICUR was € 24,203/QALY gained.Conclusion: This simulation suggests that GO + SOC could be a cost-effective option for treatment of patients with de novo AML in first line.Keywords: cost-effectiveness, gemtuzumab ozogamicin, acute myeloid leukaemia, Spain
