Economic evaluation of treosulfan in patients undergoing allogeneic haematopoietic stem cell transplantation

Author:

Bini ChiaraORCID,Paoletti MartinaORCID,Marcellusi AndreaORCID,Tomino CarloORCID,Mennini Francesco Saverio

Abstract

Objective. To assess the cost-effectiveness and economic sustainability of treosulfan plus fludarabine compared with busulfan plus fludarabine as a conditioning treatment for malignant disease prior to allogeneic haematopoietic stem cell transplantation (alloHSCT) in adult patients in Italy. Method. The two theoretical cohorts of patients aged ≥ 60 years with acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS) were pooled and followed over time using a partitioned survival model with cycles of 28 days. Patients can transition between a post-HSCT recovery/remission state (Event-Free Survival state, EFS state), a relapsed/progressed disease state, and a death state. A lifetime horizon for cost-effectiveness analysis and a 5-years’ time horizon for budget impact analysis were used. The perspective of the Italian National Health Service was adopted. Utility values were obtained from published sources. Costs included: drug acquisition, HSCT procedure, management and treatment of adverse reactions, graft-versus-host disease (GvHD) and health states, end of life treatment. Discounting of 3% per year was applied for both costs and outcomes according to Italian guidelines. Sensitivity was tested through both one-way and probabilistic analyses. Results. Cost-effectiveness analysis showed that treosulfan is both more effective and less expensive compared with busulfan (+1.11 life-years, +0.96 quality-adjusted life-years per patient and -€ 41,784 per patient). On the side of economic sustainability, the introduction of treosulfan in the market could generate a cumulative decrement of the expense incurred by NHS of about -€ 179,174 over five years. Conclusion. Treosulfan could represent a cost-effective and sustainable treatment alternative from the perspective of the NHS.

Publisher

Aboutscience Srl

Subject

Health Policy

Reference30 articles.

1. Gyurkocza B, Sandmaier BM. Conditioning regimens for hematopoietic cell transplantation: one size does not fit all. Blood. 2014;124(3):344-353. https://doi.org/10.1182/blood-2014-02-514778 PMID:24914142

2. Kröger N, Solano C, Wolschke C, et al. Antilymphocyte Globulin for Prevention of Chronic Graft-versus-Host Disease. N Engl J Med. 2016;374(1):43-53. https://doi.org/10.1056/NEJMoa1506002 PMID:26735993

3. Gratwohl A. The EBMT risk score. Bone Marrow Transplant. 2012;47(6):749-756. https://doi.org/10.1038/bmt.2011.110 PMID:21643021

4. D’Souza A, Fretham C. Current Uses and Outcomes of Hematopoietic Cell Transplantation (HCT): CIBMTR Summary Slides. 2018; Online https://www.cibmtr.org. (Accessed March 2022)

5. Kröger, N., D.W. Beelen, and D.A.f.K.-u.B.e.V. für die DAG-KBT. Conditioning. Allogeneic stem cell transplantation [In German]. 2018; Online: https://www.onkopedia.com/de/onkopedia/guidelines/allgemeine-anforderungen/@@guideline/html/index.html. (Accessed March 2022)

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3