COST-EFFECTIVENESS ANALYSIS OF QUIZARTINIB FOR FIRST-LINE TREATMENT OF FLT3-MUTATED ACUTE MYELOID LEUKEMIA IN JAPAN
Author(s)
Seiya Taniguchi, MS1, Seishiro Saiki, BS1, Ryutaro Sakai, MS1, Mao Yamaguchi, MS1, Kensuke Moriwaki, BS, MS, PhD2.
1Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan University, Kyoto, Japan.
1Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan University, Kyoto, Japan.
OBJECTIVES: FLT3-ITD-mutated acute myeloid leukemia (AML) is associated with poor prognosis. The QuANTUM-First trial demonstrated improved overall survival with quizartinib in combination with chemotherapy compared with chemotherapy alone. This study aimed to evaluate the cost-effectiveness of quizartinib from the perspective of the Japanese public healthcare payer.
METHODS: A partitioned survival analysis model was developed to estimate costs and quality-adjusted life years (QALYs) for quizartinib plus chemotherapy and chemotherapy alone. Survival data from the QuANTUM-First trial were used for the first five years, with subsequent extrapolation adjusted using Japanese life tables. Costs were estimated using the JMDC claims database. Utility weights were obtained from published literature. The incremental cost-effectiveness ratio (ICER) was calculated, and sensitivity analyses were conducted.
RESULTS: Compared with chemotherapy alone, quizartinib plus chemotherapy resulted in an incremental cost of JPY 191,773,102 and an incremental gain of 1.61 QALYs, yielding an ICER of JPY 119,291,662/QALY. Deterministic sensitivity analysis showed that the utility value in the progressed disease state had the greatest impact on the ICER. Probabilistic sensitivity analysis indicated that the probability of quizartinib being cost-effective was 0% at a willingness-to-pay threshold of JPY 15 million/QALY.
CONCLUSIONS: At a willingness-to-pay threshold of JPY 15 million/QALY, quizartinib was not cost-effective as a first-line treatment for FLT3-ITD-mutated AML in Japan. However, since the ICER is highly sensitive to overall survival extrapolation using life tables, the results should be interpreted with consideration of this long-term uncertainty.
METHODS: A partitioned survival analysis model was developed to estimate costs and quality-adjusted life years (QALYs) for quizartinib plus chemotherapy and chemotherapy alone. Survival data from the QuANTUM-First trial were used for the first five years, with subsequent extrapolation adjusted using Japanese life tables. Costs were estimated using the JMDC claims database. Utility weights were obtained from published literature. The incremental cost-effectiveness ratio (ICER) was calculated, and sensitivity analyses were conducted.
RESULTS: Compared with chemotherapy alone, quizartinib plus chemotherapy resulted in an incremental cost of JPY 191,773,102 and an incremental gain of 1.61 QALYs, yielding an ICER of JPY 119,291,662/QALY. Deterministic sensitivity analysis showed that the utility value in the progressed disease state had the greatest impact on the ICER. Probabilistic sensitivity analysis indicated that the probability of quizartinib being cost-effective was 0% at a willingness-to-pay threshold of JPY 15 million/QALY.
CONCLUSIONS: At a willingness-to-pay threshold of JPY 15 million/QALY, quizartinib was not cost-effective as a first-line treatment for FLT3-ITD-mutated AML in Japan. However, since the ICER is highly sensitive to overall survival extrapolation using life tables, the results should be interpreted with consideration of this long-term uncertainty.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE21
Topic
Economic Evaluation
Disease
SDC: Oncology