Cost-utility Analysis of Adult Patients with Severe Aplastic Anemia: a Single-center Cohort Study

Abstract

Abstract Background: This study aimed to evaluate the efficacy of cyclosporine A + ALG and cyclosporine A + TPO-RA in treating SAA (Severe Aplastic Anemia) patients and provide scientific data support for maximizing the therapeutic benefit of SAA patients. Methods: Cost-utility analysis was used to compare the two strategies' quality-adjusted years of life and total costs. Patient utility values were obtained by EQ-5D-3L and Japanese TTO conversion, and total treatment costs were obtained by electronic questionnaire and medical information data. Results: Twenty-six adult patients were enrolled, including 17 patients in the cyclosporine A + ALG group and nine in the cyclosporine A + TPO-RA group. From admission to 6 months follow-up, the intuitive feelings of patients in the cyclosporine A + ALG group were higher than of those in the cyclosporine A + TPO-RA group, and the quality of life of the former group was significantly higher than that of the latter, with a difference of 0. 08 QALY (P < 0.01). The total cost of the former was twice that of the latter. The QALYs obtained by the two strategies were 687,000 yuan and 450,000 yuan, respectively. Compared with the cyclosporine A + TPO-RA regimen, the total cost of the cyclosporine A + ALG regimen was 1.51 million yuan per additional QALY. Conclusions: Under the premise of ensuring clinical efficacy, CsA + TPO-RA can be used as a better treatment strategy to reduce the economic pressure of SAA patients, reduce the pressure of medical insurance, and obtain multi-benefits.