The cost-effectiveness of pegaspargase versus native asparaginase for first-line treatment of acute lymphoblastic leukaemia: a UK-based cost-utility analysis
| Autor: | Clare Rowntree, Peggy L. Lin, Xingdi Hu, Kingsley P. Wildman, Vaskar Saha, Subham Basu |
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| Rok vydání: | 2019 |
| Předmět: |
Asparaginase
medicine.medical_specialty Combination therapy Cost effectiveness medicine.medical_treatment 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine Pegaspargase lcsh:R5-920 Chemotherapy Cost–utility analysis Manchester Cancer Research Centre business.industry ResearchInstitutes_Networks_Beacons/mcrc Research Health Policy Acute lymphoblastic leukaemia First line treatment chemistry 030220 oncology & carcinogenesis Lymphoblastic leukaemia Cost-effectiveness lcsh:Medicine (General) business 030215 immunology medicine.drug |
| Zdroj: | Health Economics Review Health Economics Review, Vol 9, Iss 1, Pp 1-13 (2019) Hu, X, Wildman, K P, Basu, S, Lin, P L, Rowntree, C & Saha, V 2019, ' The cost-effectiveness of pegaspargase versus native asparaginase for first-line treatment of acute lymphoblastic leukaemia : A UK-based cost-utility analysis ', Health Economics Review, vol. 9, no. 1, 40 . https://doi.org/10.1186/s13561-019-0257-3 |
| ISSN: | 2191-1991 |
| Popis: | Background L-asparaginase is a key component of treatment for patients with acute lymphoblastic leukaemia (ALL) in the UK. Commonly used forms of asparaginase are native E. coli-derived asparaginase (native asparaginase) and pegaspargase in first-line combination therapy, and native Erwinia chrysanthemi-derived asparaginase (Erwinia asparaginase) as second-line treatment. The objective of this study was to evaluate the cost-effectiveness of pegaspargase versus native asparaginase in first-line combination therapy for patients with newly diagnosed ALL. A combined decision tree and health-state transition Markov cost-effectiveness model was developed to assess the relative costs and health outcomes of pegaspargase versus native asparaginase in the UK setting. Results In base case analyses, first-line pegaspargase (followed by Erwinia asparaginase in cases of hypersensitivity) dominated first-line native asparaginase followed by Erwinia asparaginase; i.e. resulted in lower costs and more quality-adjusted life year gain. The favourable hypersensitivity rates and administration profile of pegaspargase led to lifetime cost savings of £4741 versus native asparaginase. Pegaspargase remained cost-effective versus all treatment strategies in all scenario analyses, including use of the 2500 IU/m2 dose, recommended for patients ≤21 years of age. Conclusions Pegaspargase, as part of multi-drug chemotherapy, is a cost-effective option for the treatment of newly diagnosed ALL. Based on this study, The National Institute for Health and Care Excellence Technology Appraisal Committee concluded that it could recommend pegaspargase as a cost-effective use of National Health Service resources in England & Wales for treating ALL in children, young people and adults with untreated, newly diagnosed disease. Trial registration UKALL 2011, EudraCT number 2010-020924-22; UKALL 2003, EudraCT number 2007-004013-34; UKALL14, EudraCT number 2009-012717-22. |
| Databáze: | OpenAIRE |
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