THE CHOICE OF EFFECTIVENESS CRITERIA AFFECTS CONCLUSIONS OF ECONOMIC EVALUATION OF HEALTH CARE INNOVATIONS- EXAMPLE BASED ON A RANDOMISED MULTICENTER TRIAL COMPARING TWO REDUCED INTENSITY CONDITIONING REGIMEN (FLU-BU-ATG) VS. (FLU-TBI) FOR ...
Author(s)
Le Corroller Soriano A1, Siani C2, Tabrizi R3, Bay J4, Boher J5, Faucher C5, Blaise D5
1Aix-Marseille University, Marseille, France, 2ISPB, Faculte de Pharmacie, Lyon, France, University Lyon 1, University of Lyon, Lyon, France, 3CHU Bordeaux, Pessac, France, 4CHU de Clermont-Ferrand - Hôpital d'Estaing, Clermont-Ferrand, France, 5Institut Paoli-Calmettes, Marseille, France
OBJECTIVES: Our study compared cost-effectiveness analyses using three different effectiveness criteria : the PFS, the OS and the QALY on the basis of a multicenter randomized trial comparing two Reduced Intensity conditioning regimen for matched related Allo-SCT published in 2013 (Blaise et al, Cancer, METHODS: RESULTS: At five years, OS and PFS did not statistically differ between groups. The mean total cost per patient was not statistically different between groups (111725€ for FBA vs 98316€ for FTBI, NS). Using PFS as endpoint, the ICER of FBA compared to FTBI is 35034 € per year of PFS gained, and the probability of FBA being a cost-effective choice of treatment was ~70% at the willingness-to-pay level of euros 50 000/year of PFS gained. Using OS, the ICER became non-statistically significant. Using QALY the ICER is non-statistically significant again, even considering 3 weighted health states (DFS, progression and death) and 4 weighted health states (DFS without GVHD, DFS with GVHD, progression and death) for the QALY calculation CONCLUSIONS: The choice of effectiveness criteria is crucial since it affects conclusions of economic evaluation. Using Intermediary endpoints allows economic evaluation to be available earlier in the life cycle of an innovation. However, it implies strong hypotheses about the predictive value of the PFS over the OS, and it does not include quality of life considerations. Longer period evaluation and QALY may reverse preliminary results.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCN154
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Oncology