Cost utility of interferon-α vs hydroxycarbamide in CML
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INTERNATIONAL RESEARCH & OPINION Cost utility of interferon-a vs hydroxycarbamide in CML Patients with chronic myelogenous leukaemia (CML) treated with interferon-a lived around 18 months longer at an incremental discounted cost of $US34 8001 quality-adjusted life-year (QALY) gained, compared with hydroxycarbamide treatment, according to the results of an international multicentre study.l The researchers used decision analysis and a Markov model to compare the cost effectiveness of interferon-a with hydroxycarbamide. The model comprised the 2 treatment arms and 8 states of health from complete remission to death. Clinical outcomes and probability values were obtained from large North American and European clinical trials, while costs were obtained from 3 major US and 3 major European cancer centres. The increased survival associated with interferon-a therapy (median survival estimates were 69 vs 58 months with hydroxycarbamide) comes at a higher cost, both in terms of dollars and reduced quality of life (QOL) from interferon-related adverse effects. ResuUs sensitive to age and inteIferon-a costs The cost-utility values were strongly propelled by the cost of interferon-a. Reducing the cost of interferon-a by one-third was estimated to reduce the incremental cost-utility to $USI9 300/QALY gained. The adverse effect profile of interferon-a also produced large changes in the model. If interferon-a reduced patient QOL by 38%, compared with hydroxycarbamide, the quality-adjusted life expectancies of both treatments would be equal. Interferon-a was most cost effective in patients aged 30 years (incremental cost of $US30 8301 QALY), while the incremental costlQALY increased to $US61 200 in patients aged 70 years. Similar costs to other therapies Commenting on the study, Dr Ernest Borden of the University of Maryland Cancer Center, US, and Dr David Parkinson of the US National Cancer Institute point out that the incremental cost effectiveness of interferon-a in CML ($US26 500llife-year saved) 'is similar to those of other accepted therapies '.2 'Interferons are proving to be effective therapy for an increasing number of defined indications, even when cost effectiveness and adverse effects on quality of life are considered . . Tne toxicities pnxluced by interferon-a are not considered 'trivial' but the chronic effects do subside after a few weeks in most patients, maintain Drs Borden and Parkinson. They believe that it is for this reason that more QOL analyses are needed. 1. Kattan MW. et aI. Cost-effectiveness of interferon-alpha and conventional chemotherapy in chronic myelogenous leukemia. Annals of Internal Medicine 125: 541-548. I Oct 1996 2. Borden EC. et aI. Interferons: effectiveness. toxicities. and costs. Annals of Internal Medicine 125: 614-616. I Oct 1996 800458162 1173-550319610083-00091$01.00° Adl. International Limited 1996. All rights rnarved PharmacoEconomics & Outcomes News 12 Oct 1996 No. 83 9 INTERNATIONAL RESEARCH & OPINION Cost utility of interferon-a vs hydroxycarbamide in CML Patients with chronic myelogenous leukaemia (CML) treated with interferon-a lived around 18 months longer at an incremental discounted cost of $US34 8001 quality-adjusted life-year (QALY) gained, compared with hydroxycarbamide treatment, according to the results of an international multicentre study.l The researchers used decision analysis and a Markov model to compare the cost effectiveness of interferon-a with hydroxycarbamide. The model comprised the 2 treatment arms and 8 states of health from complete remission to death. Clinical outcomes and probability values were obtained from large North American and European clinical trials, while costs were obtained from 3 major US and 3 major European cancer centres. The increased survival associated with interferon-a therapy (median survival estimates were 69 vs 58 months with hydroxycarbamide) comes at a higher cost, both in terms of dollars and reduced quality of life (QOL) from interferon-related adverse effects. ResuUs sensitive to age and inteIferon-a costs The cost-utility values were strongly propelled by the cost of interferon-a. Reducing the cost of interferon-a by one-third was estimated to reduce the incremental cost-utility to $USI9 300/QALY gained. The adverse effect profile of interferon-a also produced large changes in the model. If interferon-a reduced patient QOL by 38%, compared with hydroxycarbamide, the quality-adjusted life expectancies of both treatments would be equal. Interferon-a was most cost effective in patients aged 30 years (incremental cost of $US30 8301 QALY), while the incremental costlQALY increased to $US61 200 in patients aged 70 years. Similar costs to other therapies Commenting on the study, Dr Ernest Borden of the University of Maryland Cancer Center, US, and Dr David Parkinson of the US National Cancer Institute point out that the incremental cost effectiveness of interferon-a in CML ($US26 500llife-year saved) 'is similar to those of other accepted therapies '.2 'Interferons are proving to be effective therapy for an increasing number of defined indications, even when cost effectiveness and adverse effects on quality of life are considered . . Tne toxicities pnxluced by interferon-a are not considered 'trivial' but the chronic effects do subside after a few weeks in most patients, maintain Drs Borden and Parkinson. They believe that it is for this reason that more QOL analyses are needed. 1. Kattan MW. et aI. Cost-effectiveness of interferon-alpha and conventional chemotherapy in chronic myelogenous leukemia. Annals of Internal Medicine 125: 541-548. I Oct 1996 2. Borden EC. et aI. Interferons: effectiveness. toxicities. and costs. Annals of Internal Medicine 125: 614-616. I Oct 1996 800458162 1173-550319610083-00091$01.00° Adl. International Limited 1996. All rights rnarved PharmacoEconomics & Outcomes News 12 Oct 1996 No. 83 9
Transcript of Cost utility of interferon-α vs hydroxycarbamide in CML
INTERNATIONAL RESEARCH & OPINION
Cost utility of interferon-a vs hydroxycarbamide in CML
Patients with chronic myelogenous leukaemia (CML) treated with interferon-a lived around 18 months longer at an incremental discounted cost of $US34 8001 quality-adjusted life-year (QALY) gained, compared with hydroxycarbamide treatment, according to the results of an international multicentre study.l
The researchers used decision analysis and a Markov model to compare the cost effectiveness of interferon-a with hydroxycarbamide. The model comprised the 2 treatment arms and 8 states of health from complete remission to death. Clinical outcomes and probability values were obtained from large North American and European clinical trials, while costs were obtained from 3 major US and 3 major European cancer centres.
The increased survival associated with interferon-a therapy (median survival estimates were 69 vs 58 months with hydroxycarbamide) comes at a higher cost, both in terms of dollars and reduced quality of life (QOL) from interferon-related adverse effects.
ResuUs sensitive to age and inteIferon-a costs The cost-utility values were strongly propelled by
the cost of interferon-a. Reducing the cost of interferon-a by one-third was estimated to reduce the incremental cost-utility to $USI9 300/QALY gained. The adverse effect profile of interferon-a also produced large changes in the model. If interferon-a reduced patient QOL by 38%, compared with hydroxycarbamide, the quality-adjusted life expectancies of both treatments would be equal. Interferon-a was most cost effective in patients aged 30 years (incremental cost of $US30 8301 QALY), while the incremental costlQALY increased to $US61 200 in patients aged 70 years.
Similar costs to other therapies Commenting on the study, Dr Ernest Borden of the
University of Maryland Cancer Center, US, and Dr David Parkinson of the US National Cancer Institute point out that the incremental cost effectiveness of interferon-a in CML ($US26 500llife-year saved) 'is similar to those of other accepted therapies '.2
'Interferons are proving to be effective therapy for an increasing number of defined indications, even when cost effectiveness and adverse effects on quality of life are considered .. Tne toxicities pnxluced by interferon-a are not considered 'trivial' but the chronic effects do subside after a few weeks in most patients, maintain Drs Borden and Parkinson. They believe that it is for this reason that more QOL analyses are needed. 1. Kattan MW. et aI. Cost-effectiveness of interferon-alpha and conventional chemotherapy in chronic myelogenous leukemia. Annals of Internal Medicine 125: 541-548. I Oct 1996 2. Borden EC. et aI. Interferons: effectiveness. toxicities. and costs. Annals of Internal Medicine 125: 614-616. I Oct 1996
800458162
1173-550319610083-00091$01.00° Adl. International Limited 1996. All rights rnarved PharmacoEconomics & Outcomes News 12 Oct 1996 No. 83
9 INTERNATIONAL RESEARCH & OPINION
Cost utility of interferon-a vs hydroxycarbamide in CML
Patients with chronic myelogenous leukaemia (CML) treated with interferon-a lived around 18 months longer at an incremental discounted cost of $US34 8001 quality-adjusted life-year (QALY) gained, compared with hydroxycarbamide treatment, according to the results of an international multicentre study.l
The researchers used decision analysis and a Markov model to compare the cost effectiveness of interferon-a with hydroxycarbamide. The model comprised the 2 treatment arms and 8 states of health from complete remission to death. Clinical outcomes and probability values were obtained from large North American and European clinical trials, while costs were obtained from 3 major US and 3 major European cancer centres.
The increased survival associated with interferon-a therapy (median survival estimates were 69 vs 58 months with hydroxycarbamide) comes at a higher cost, both in terms of dollars and reduced quality of life (QOL) from interferon-related adverse effects.
ResuUs sensitive to age and inteIferon-a costs The cost-utility values were strongly propelled by
the cost of interferon-a. Reducing the cost of interferon-a by one-third was estimated to reduce the incremental cost-utility to $USI9 300/QALY gained. The adverse effect profile of interferon-a also produced large changes in the model. If interferon-a reduced patient QOL by 38%, compared with hydroxycarbamide, the quality-adjusted life expectancies of both treatments would be equal. Interferon-a was most cost effective in patients aged 30 years (incremental cost of $US30 8301 QALY), while the incremental costlQALY increased to $US61 200 in patients aged 70 years.
Similar costs to other therapies Commenting on the study, Dr Ernest Borden of the
University of Maryland Cancer Center, US, and Dr David Parkinson of the US National Cancer Institute point out that the incremental cost effectiveness of interferon-a in CML ($US26 500llife-year saved) 'is similar to those of other accepted therapies '.2
'Interferons are proving to be effective therapy for an increasing number of defined indications, even when cost effectiveness and adverse effects on quality of life are considered .. Tne toxicities pnxluced by interferon-a are not considered 'trivial' but the chronic effects do subside after a few weeks in most patients, maintain Drs Borden and Parkinson. They believe that it is for this reason that more QOL analyses are needed. 1. Kattan MW. et aI. Cost-effectiveness of interferon-alpha and conventional chemotherapy in chronic myelogenous leukemia. Annals of Internal Medicine 125: 541-548. I Oct 1996 2. Borden EC. et aI. Interferons: effectiveness. toxicities. and costs. Annals of Internal Medicine 125: 614-616. I Oct 1996
800458162
1173-550319610083-00091$01.00° Adl. International Limited 1996. All rights rnarved PharmacoEconomics & Outcomes News 12 Oct 1996 No. 83
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