Cost-Effectiveness Analysis of Quizartinib for Adult Patients With Newly Diagnosed FLT3-ITD+ Acute Myeloid Leukemia (AML) in Spain
Author(s)
Concha Martínez Cano, MBA1, Sudhir Unni, MBA, PhD2, Efthalia Nikoglou, MBA, MSc, Other3, Chuyi Zhang4, Anna Maria Vanessa Gittfried, MSc5.
1Daiichi Sankyo España, S.A.U., Madrid, Spain, 2Daiichi Sankyo, Basking Ridge, NJ, USA, 3Daiichi Sankyo Europe GmbH, Zurich, Switzerland, 4IQVIA, London, United Kingdom, 5OPEN Health, Rotterdam, Netherlands.
1Daiichi Sankyo España, S.A.U., Madrid, Spain, 2Daiichi Sankyo, Basking Ridge, NJ, USA, 3Daiichi Sankyo Europe GmbH, Zurich, Switzerland, 4IQVIA, London, United Kingdom, 5OPEN Health, Rotterdam, Netherlands.
OBJECTIVES: The presence of FLT3-ITD mutation is associated with poor prognosis and survival in AML. Despite treatment improvements, patients continue to experience high relapse rates. Quizartinib, indicated in combination with standard cytarabine and anthracycline induction and standard cytarabine consolidation chemotherapy, followed as a single-agent maintenance for adult patients with newly diagnosed FLT3+ AML, presents an innovative option for these patients. This study evaluated the cost-effectiveness of quizartinib in induction, consolidation and 36 cycles of maintenance compared to induction and consolidation with midostaurin in combination with standard daunorubicin and cytarabine induction and high-dose cytarabine consolidation and 12 cycles of maintenance with midostaurin alone in Spain.
METHODS: An eleven-state semi-Markov model was developed, incorporating first-line and subsequent treatments, with a 28-day cycle length. Comparative evidence for key clinical parameters, including relapse-free survival and overall survival, were generated from an indirect treatment comparison utilizing clinical trial data from QuANTUM-First (quizartinib) and RATIFY (midostaurin). Healthcare resource utilization and direct costs were identified from Spanish databases and public sources. A 3% discount rate was applied to costs and outcomes. Sensitivity analysis was conducted to test the robustness of the deterministic results.
RESULTS: Over a lifetime horizon, the base-case results indicate that quizartinib is a cost-effective treatment regimen compared to the midostaurin regimen, with an ICER of 4,239 €/QALY (list price). The clinical benefit was primarily attributable to a statistically significant reduction in relapse risk after complete remission (HR 0.42, 95% CI: 0.20, 0.91). The greatest cost driver was a longer maintenance treatment for quizartinib. The greatest cost savings were observed in subsequent treatments, disease management, and management of treatment-related adverse events.
CONCLUSIONS: This analysis indicated that quizartinib is a cost-effective strategy compared to midostaurin, positioning it as a promising treatment option for patients with newly diagnosed FLT3-ITD+ AML from the Spanish National Health Service perspective.
METHODS: An eleven-state semi-Markov model was developed, incorporating first-line and subsequent treatments, with a 28-day cycle length. Comparative evidence for key clinical parameters, including relapse-free survival and overall survival, were generated from an indirect treatment comparison utilizing clinical trial data from QuANTUM-First (quizartinib) and RATIFY (midostaurin). Healthcare resource utilization and direct costs were identified from Spanish databases and public sources. A 3% discount rate was applied to costs and outcomes. Sensitivity analysis was conducted to test the robustness of the deterministic results.
RESULTS: Over a lifetime horizon, the base-case results indicate that quizartinib is a cost-effective treatment regimen compared to the midostaurin regimen, with an ICER of 4,239 €/QALY (list price). The clinical benefit was primarily attributable to a statistically significant reduction in relapse risk after complete remission (HR 0.42, 95% CI: 0.20, 0.91). The greatest cost driver was a longer maintenance treatment for quizartinib. The greatest cost savings were observed in subsequent treatments, disease management, and management of treatment-related adverse events.
CONCLUSIONS: This analysis indicated that quizartinib is a cost-effective strategy compared to midostaurin, positioning it as a promising treatment option for patients with newly diagnosed FLT3-ITD+ AML from the Spanish National Health Service perspective.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE217
Topic
Economic Evaluation
Disease
Oncology, Personalized & Precision Medicine