Costs Per Responder With Venetoclax in Combination With Azacitidine in Unfit Patients With Previously Untreated Acute Myeloid Leukemia in China

OBJECTIVES: Acute myeloid leukemia (AML) is an aggressive malignancy of the white blood cells and approximately half of patients are ineligible for intensive chemotherapy (unfit AML). These patients are generally offered lower-intensity regimens, however, the efficacy is unsatisfactory. Venetoclax has demonstrated clinically meaningful improvement in combination with azacitidine (Ven+AZA) in unfit AML patients. This study aims to evaluate the costs per responder comparing Ven+AZA versus AZA, which is a more concise and intuitive analysis method than cost-utility analysis, for newly diagnosed patients with unfit AML from the healthcare system perspective so as to support the treatment decision-making in China.

METHODS: Costs per responder defined as total annual costs per patient divided by the rate of composite complete remission (CR/CRi). The CR/CRi rates of Asian group in the VIALE-A trial were used to better represent the efficacy of Ven and Ven+AZA in China. The annual treatment costs incorporate treatment-related direct medical costs, including the costs of drug and administration, healthcare resources utilization (blood transfusion, laboratory and radiological tests, anti-infective therapy, outpatient visits and hospitalization), and adverse event management. Cost inputs were mainly derived from published literature and publicly available prices.

RESULTS: Compared to AZA, VEN+AZA has a higher CR/CRi rate (70.49% vs. 28.13%) and lower health utilization costs (significant saving in blood transfusion, anti-infection, hospitalization, and adverse event management), with annual treatment costs of 198,975 CNY and 221,747 CNY, respectively. For patients treated with VEN + AZA, the cost per responder amounted to only 282,267 CNY, resulting in savings of more than 500,000 CNY compared with the cost of AZA, which was 788,433 CNY.

CONCLUSIONS: From the China healthcare system perspective, Ven + AZA provides a more economical treatment option with lower cost per responder compared with AZA in newly diagnosed unfit AML patients.