Real-world cost-effectiveness in chronic myeloid leukemia: the price of success during four decades of development from non-targeted treatment to imatinib

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Real-world cost-effectiveness in chronic myeloid leukemia: the price of success during four decades of development from non-targeted treatment to imatinib. / Ohm, Lotta; Lundqvist, Adam; Dickman, Paul; Hoglund, Martin; Persson, Ulf; Stenke, Leif; Carlsson, Katarina Steen; Bjorkholm, Magnus.

I: Leukemia & Lymphoma, Vol. 56, Nr. 5, 2015, s. 1385-1391.

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Ohm, Lotta ; Lundqvist, Adam ; Dickman, Paul ; Hoglund, Martin ; Persson, Ulf ; Stenke, Leif ; Carlsson, Katarina Steen ; Bjorkholm, Magnus. / Real-world cost-effectiveness in chronic myeloid leukemia: the price of success during four decades of development from non-targeted treatment to imatinib. I: Leukemia & Lymphoma. 2015 ; Vol. 56, Nr. 5. s. 1385-1391.

RIS

TY - JOUR

T1 - Real-world cost-effectiveness in chronic myeloid leukemia: the price of success during four decades of development from non-targeted treatment to imatinib

AU - Ohm, Lotta

AU - Lundqvist, Adam

AU - Dickman, Paul

AU - Hoglund, Martin

AU - Persson, Ulf

AU - Stenke, Leif

AU - Carlsson, Katarina Steen

AU - Bjorkholm, Magnus

PY - 2015

Y1 - 2015

N2 - Imatinib has revolutionized the treatment of chronic myeloid leukemia (CML). We evaluated clinical outcome and cost-effectiveness, using Swedish registry data based on patients with CML diagnosed 1973-2008. Outcome from three time periods (I: 1973-1979; II: 1991-1997; III: 2002-2008) associated with symptomatic treatment, interferon-alpha/stem cell transplant and implementation of imatinib, respectively, were compared and a lifetime cost-effectiveness model developed. Survival data from population registries, estimated resource use from clinical practice and quality of life estimates were employed. Substantial health gains were noted over time, paralleled by increased treatment costs. Median survival was 1.9, 4.0 and 13 years during the respective time periods. The incremental cost-effectiveness ratio (ICER) between periods III and II was (sic)52 700 per quality-adjusted life year (QALY) gained. An estimated 80% price reduction of imatinib, related to patent expiry, would reduce this ICER to (sic)22 700. Our data from four decades reveal dramatically improved survival in CML, paralleled by ICER levels generally accepted by health authorities.

AB - Imatinib has revolutionized the treatment of chronic myeloid leukemia (CML). We evaluated clinical outcome and cost-effectiveness, using Swedish registry data based on patients with CML diagnosed 1973-2008. Outcome from three time periods (I: 1973-1979; II: 1991-1997; III: 2002-2008) associated with symptomatic treatment, interferon-alpha/stem cell transplant and implementation of imatinib, respectively, were compared and a lifetime cost-effectiveness model developed. Survival data from population registries, estimated resource use from clinical practice and quality of life estimates were employed. Substantial health gains were noted over time, paralleled by increased treatment costs. Median survival was 1.9, 4.0 and 13 years during the respective time periods. The incremental cost-effectiveness ratio (ICER) between periods III and II was (sic)52 700 per quality-adjusted life year (QALY) gained. An estimated 80% price reduction of imatinib, related to patent expiry, would reduce this ICER to (sic)22 700. Our data from four decades reveal dramatically improved survival in CML, paralleled by ICER levels generally accepted by health authorities.

KW - Chronic myeloid leukemia

KW - survival

KW - population-based

KW - costs

KW - imatinib

KW - lifetime simulation

U2 - 10.3109/10428194.2014.953141

DO - 10.3109/10428194.2014.953141

M3 - Article

VL - 56

SP - 1385

EP - 1391

JO - Leukemia & Lymphoma

T2 - Leukemia & Lymphoma

JF - Leukemia & Lymphoma

SN - 1029-2403

IS - 5

ER -