COST EFFECTIVENESS OF MIDOSTAURIN IN ADDITION TO STANDARD CARE VERSUS STANDARD CARE ALONE IN FIRST LINE TREATMENT OF ACUTE MYELOD LEUKEMIA WITH FLT3 MUTATION FROM THE PERSPECTIVE OF CHILEAN HEALTH SYSTEM
Author(s)
Rojas R
Fractal EDM, Santiago, Chile
OBJECTIVES: The aim of this analysis was to estimate the cost-effectiveness of Midostaurin in addition to standard care as first line treatment for acute myeloid leukemia in patients with FLT3 mutation from the perspective of Chilean health system. METHODS: A partitioned cohort model was adapted in order to represent the natural evolution of the disease. Estimation of resource usage and costs was performed from the perspective of public payer. Expected costs were measured in Chilean pesos (1 USD = 650 CLP) and benefits in quality adjusted life years (QALYs). Other outcomes represented were rate of response and life years. Health related quality of life was estimated from published literature. A lifetime time horizon was used and a 3% discount rate was considered for costs and outcomes. A probabilistic sensitivity analysis was performed to account for uncertainty. RESULTS: The total expected costs of treating acute myeloid leukemia with Midostaurin plus standard therapy are higher than standard therapy alone (USD148,128 and USD76,909 respectively). Similarly, the expected incremental health benefit is higher in Midostaurin group (1.57 incremental QALYs). The base case scenario (current market prices for all treatments) shows an average ICER of Midostaurin in addition to standard care versus standard therapy of USD 45,470/QALY. The ICER is reduced to USD 38,904 when the base price of Midostaurin is reduced a 25%. Both ICERs are between the cost effectiveness threshold range suggested by WHO of 1 to 3 GDPs per capita. Deterministic sensitivity analysis shows a high impact of price, hazard ratio, rate of stem cell therapy and maintenance therapy duration as drivers of change of incremental cost-effectiveness ratio CONCLUSIONS: Estimates of cost effectiveness ratio of Midostaurin can be considered as cost effective for Chilean health system. The assessed intervention delivers high gains in life years and quality adjusted life years in comparison with standard care.
Conference/Value in Health Info
2019-05, ISPOR 2019, New Orleans, LA, USA
Value in Health, Volume 22, Issue S1 (2019 May)
Code
PCN78
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Oncology