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COST-EFFECTIVENESS OF ALEMTUZUMAB FOR T-CELL PROLYMPHOCYTIC LEUKEMIA

Published online by Cambridge University Press:  14 September 2012

Lanting Lu ,
Jaime Peters ,
Chris Roome  and
Ken Stein
Lanting Lu
Affiliation:
Unviersity of Exeter email: [email protected]
Jaime Peters
Affiliation:
University of Exeter
Chris Roome
Affiliation:
NHS Devon
Ken Stein
Affiliation:
University of Exeter
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Abstract

Objectives: The aim of this study was to evaluate the cost-effectiveness of alemtuzumab (CAMPATH-1H) compared with conventional chemotherapy in people with T-cell prolymphocytic leukemia (T-PLL).

Methods: We developed a decision-analytic model to assess the costs and benefits of alemtuzumab or conventional therapy based on their effects on quality of life of patients. The main outcome was the incremental cost-effectiveness ratio incorporating costs per additional quality-adjusted life-year (QALY) gained over lifetime. Due to the limited data available, a large number of assumptions had to be made to construct the cost-utility model. One-way, multi-way, and probabilistic sensitivity analyses (PSA) were conducted to explore the impact of these uncertainties. Expected values of perfect information were also calculated for four specific scenarios.

Results: Depending on different key assumptions made, the PSA suggested distinct conclusions using a willingness-to-pay threshold of 30,000 GBP per QALY gained. Using this threshold, the probability that alemtuzumab would be cost-effective varies from 0 percent to 53 percent for the four modeled scenarios. Population expected value of perfect information analysis suggests that resolving the parameter uncertainty in the analysis for people with T-PLL in the United Kingdom would have considerable value—up to 5.3 million euro.

Conclusions: Alemtuzumab appears more likely to be cost-effective if used earlier in the course of T-PLL and where it replaces the use of multiple alternative therapies. However, cost-effectiveness is highly uncertain and future research is clearly justified. Nevertheless, our analysis demonstrates the feasibility of considering the cost-effectiveness of an agent despite the presence of significant uncertainty to provide appropriate assessment information to policy makers.

Keywords

Cost-utility analysisAlemtuzumabT-cell prolymphocytic leukemiaValue of information analysisProbabilistic sensitivity analysis
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 28 , Issue 3 , July 2012 , pp. 241 - 248
Copyright
Copyright © Cambridge University Press 2012

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References

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