COST-EFFECTIVENESS ANALYSIS OF VENETOCLAX FOR TREATMENT OF REFRACTORY/RELAPSED CHRONIC LYMPHOCYTIC LEUKEMIA WITH OR WITHOUT 17P DELETION IN BULGARIA
Author(s)
Djambazov S, Veleva N, Tsanova D, Vekov T
Medical University Pleven, Pleven, Bulgaria
COST-EFFECTIVENESS ANALYSIS OF VENETOCLAX FOR TREATMENT OF REFRACTORY/RELAPSED CHRONIC LYMPHOCYTIC LEUKEMIA WITH OR WITHOUT 17p DELETION IN BULGARIA
Djambazov S , Veleva N , Tsanova D , Vekov T
Faculty of Pharmacy, Medical University – Pleven, Pleven, Bulgaria
Faculty of Public Health, Medical University – Pleven, Pleven, Bulgaria OBJECTIVES: Modeling cost and health benefits of VEN for Bulgaria compared to best supporting care (BSC) for a third treatment line. An indirect comparison of therapeutic alternatives for the first therapeutic line in patients with CLL ± del 17p/TP53 mut and the second therapeutic line in patients with R/R CLL ± del17p/TP53 mut was performed. METHODS: Identification and analysis of published data from health technology assessment for treatment of relapsing/refractory CLL (R/R CLL) ± del 17p/TP53 mut in other countries. Literature search of published data on health technology assessment for treatment of R/RCLL ± del17p/ TP53 mut (January 2005-2017). Network meta-analysis, including also modeled data of health utilities and costs of VEN vs. BSC, discounted at 5%. The Markov model was applied with time horizon of 20 years. The indirect comparison includes VEN, BSC, ibrutinib (IBR), rituximab (RIT), bendamustine (BEN), idelalisib (IDE), ofatumumab (OFA). RESULTS: In the group of patients with CLL del 17p/TP53 mut VEN dominates IBR with better efficacy and lower costs: VEN vs. IDE/RIT (ICER 12 212 BGN/QALY), VEN vs. RIT/BEN (ICER 21 485 BGN/QALY). In the group of patients with R/R CLL, refractory to one previous therapy, VEN dominates IBR with better efficacy and lower costs; VEN vs. OFA/BEN (ICER 9931 BGN/QALY); VEN vs. RIT/BEN (ICER 39 085BGN/QALY) and VEN vs. IDE/RIT (ICER 12 212 BGN/QALY). CONCLUSIONS: VEN is a cost effective health technology in comparison with the therapeutic alternatives for treatment of CLL with and without the presence of del17p/TP53 mut in Bulgaria. Key words: HTA, Bulgaria, health technology assessment, venetoclax, chronic lymphocytic leukemiaConference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PRM134
Topic
Methodological & Statistical Research
Topic Subcategory
Modeling and simulation
Disease
Oncology