文章基本信息

标题：Economic Analysis of Alemtuzumab (MabCampath®) in Fludarabinerefractory Chronic Lymphocytic Leukemia
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作者：Mittmann, N. ; K. Isogai, P. ; M. Connors, J. 等
期刊名称：The Open Pharmacoeconomics & Health Economics Journal
电子版ISSN：1876-8245
出版年度：2012
卷号：4
期号：1
页码：18-25
DOI：10.2174/1876824501204010018
出版社：Bentham open
摘要：
Background: The objective of this economic analysis is to determine the cost-effectiveness of alemtuzumab in the treatment of B cell chronic lymphocytic leukemia (B-CLL) patients who have progressed despite fludarabine therapy.

Method: This model was developed according to the Canadian public payer health system considering only direct medical costs. Effectiveness information was obtained from the published literature. Resource utilization was based on guidelines, literature and expert opinion. Cost information was obtained from provincial costing sources and presented in 2008 Canadian dollars. The primary comparators for this analysis were alemtuzumab, Various Treatments (VT) (combination of agents), fludarabine+cyclophosphamide (FC), fludarabine+cyclophosphamide+rituximab (FCR) and best supportive care (BSC).

Results: Estimated mean survival for alemtuzumab was 22.68 months (1.89 years). Mean survival for VT was estimated from the literature at 16.32 months (1.36 years). The mean survival for FC was 17.44 months (1.45 years) and FCR 20.06 months (1.67 years). The incremental cost-effectiveness ratio (ICER) for alemtuzumab vs VT was $43,615/life year gained (LYG); $52,536/LYG for the alemtuzumab vs FC; $21,818/LYG vs FCR; and less costly and more effective vs BSC. ICERs were sensitive to three variables: treatment duration of alemtuzumab; treatment duration of FCR; and additional survival due to rituximab for FCR patients compared to FC.

Conclusions: The results showed that the ICERs for alemtuzumab in B-CLL patients who have failed fludarabine ranged from $21,818/LYG to $52,536/LYG compared to active treatment, and was less costly and more efficacious compared to BSC.