Cost-effectiveness analysis alongside the inter-B-NHL ritux 2010 trial: rituximab in children and adolescents with B cell non-Hodgkin's lymphoma.

Autor: Lueza B; Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Université Paris-Saclay, 114 Rue Edouard Vaillant, 94805, Villejuif Cedex, France.; Oncostat CESP - Labeled Ligue Contre le Cancer, INSERM 1018, Université Paris-Saclay, UVSQ, Villejuif, France., Aupérin A; Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Université Paris-Saclay, 114 Rue Edouard Vaillant, 94805, Villejuif Cedex, France.; Oncostat CESP - Labeled Ligue Contre le Cancer, INSERM 1018, Université Paris-Saclay, UVSQ, Villejuif, France., Rigaud C; Département de Cancérologie de l'Enfant et l'adolescent, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France., Gross TG; Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO, USA., Pillon M; Pediatric Hematology and Oncology, University of Padova, Padua, Italy., Delgado RF; Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain., Uyttebroeck A; Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Louvain, Belgium., Amos Burke GA; Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK., Zsíros J; Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands., Csóka M; 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary., Simonin M; Department of Pediatric Oncology and Hematology, Armand Trousseau Hospital-APHP, Sorbonne University, Paris, France., Patte C; Département de Cancérologie de l'Enfant et l'adolescent, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France., Minard-Colin V; Département de Cancérologie de l'Enfant et l'adolescent, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France.; INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France., Bonastre J; Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Université Paris-Saclay, 114 Rue Edouard Vaillant, 94805, Villejuif Cedex, France. julia.bonastre@gustaveroussy.fr.; Oncostat CESP - Labeled Ligue Contre le Cancer, INSERM 1018, Université Paris-Saclay, UVSQ, Villejuif, France. julia.bonastre@gustaveroussy.fr.
Jazyk: angličtina
Zdroj: The European journal of health economics : HEPAC : health economics in prevention and care [Eur J Health Econ] 2024 Mar; Vol. 25 (2), pp. 307-317. Date of Electronic Publication: 2023 Apr 14.
DOI: 10.1007/s10198-023-01581-y
Abstrakt: Objectives: The randomized controlled trial Inter-B-NHL ritux 2010 showed overall survival (OS) benefit and event-free survival (EFS) benefit with the addition of rituximab to standard Lymphomes Malins B (LMB) chemotherapy in children and adolescents with high-risk, mature B cell non-Hodgkin's lymphoma. Our aim was to assess the cost-effectiveness of rituximab-chemotherapy versus chemotherapy alone in the French setting.
Methods: We used a decision-analytic semi-Markov model with four health states and 1-month cycles. Resource use was prospectively collected in the Inter-B-NHL ritux 2010 trial (NCT01516580). Transition probabilities were assessed from patient-level data from the trial (n = 328). In the base case analysis, direct medical costs from the French National Insurance Scheme and life-years (LYs) were computed in both arms over a 3-year time horizon. Incremental net monetary benefit and cost-effectiveness acceptability curve were computed through a probabilistic sensitivity analysis. Deterministic sensitivity analysis and several sensitivity analyses on key assumptions were also conducted, including one exploratory analysis with quality-adjusted life years as the health outcome.
Results: OS and EFS benefits shown in the Inter-B-NHL ritux 2010 trial translated into the model by rituximab-chemotherapy being the most effective and also the least expensive strategy over the chemotherapy strategy. The mean difference in LYs between arms was 0.13 [95% CI 0.02; 0.25], and the mean cost difference € - 3 710 [95% CI € - 17,877; € 10,525] in favor of rituximab-chemotherapy group. For a € 50,000 per LY willingness-to-pay threshold, the probability of the rituximab-chemotherapy strategy being cost-effective was 91.1%. All sensitivity analyses confirmed these findings.
Conclusion: Adding rituximab to LMB chemotherapy in children and adolescents with high-risk mature B-cell non-Hodgkin's lymphoma is highly cost-effective in France.
Trial Registration: ClinicalTrials.gov identifier: NCT01516580.
(© 2023. The Author(s).)
Databáze: MEDLINE
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