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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 LU ; Stenke, Leif; Carlsson, Katarina Steen and Bjorkholm, Magnus (2015) In Leukemia & Lymphoma 56(5). p.1385-1391
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Chronic myeloid leukemia, survival, population-based, costs, imatinib, lifetime simulation
in
Leukemia & Lymphoma
volume
56
issue
5
pages
1385 - 1391
publisher
Taylor & Francis
external identifiers
  • wos:000356532000047
  • scopus:84932148793
ISSN
1042-8194
DOI
10.3109/10428194.2014.953141
language
English
LU publication?
yes
id
5aeda821-e0e8-4cf5-86e4-c1ff6e873287 (old id 7791118)
date added to LUP
2015-09-01 16:10:26
date last changed
2017-10-22 04:16:08
@article{5aeda821-e0e8-4cf5-86e4-c1ff6e873287,
  abstract     = {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.},
  author       = {Ohm, Lotta and Lundqvist, Adam and Dickman, Paul and Hoglund, Martin and Persson, Ulf and Stenke, Leif and Carlsson, Katarina Steen and Bjorkholm, Magnus},
  issn         = {1042-8194},
  keyword      = {Chronic myeloid leukemia,survival,population-based,costs,imatinib,lifetime simulation},
  language     = {eng},
  number       = {5},
  pages        = {1385--1391},
  publisher    = {Taylor & Francis},
  series       = {Leukemia & Lymphoma},
  title        = {Real-world cost-effectiveness in chronic myeloid leukemia: the price of success during four decades of development from non-targeted treatment to imatinib},
  url          = {http://dx.doi.org/10.3109/10428194.2014.953141},
  volume       = {56},
  year         = {2015},
}