COST-EFFECTIVENESS OF AZACITIDINE COMPARED WITH LOW-DOSES OF CHEMOTHERAPY (LDC) IN MYELODYSPLASTIC SYNDROME (MDS).
Author(s)
Candelaria-Hernández M1, López Karpovitch X2, Mijangos-Huesca FJ3, Montaño-Figueroa E4, Lemus-Carmona EA5, Guzmán-Vázquez S6, Díaz-Martínez JP6, Soto-Molina H6
1National Institute of Cancerology, Mexico City, Mexico, 2National Institute of Medical Sciences and Nutrition Salvador Zubirán (INCMNSZ), Mexico City, Mexico, 3PEMEX Hospital, Mexico City, Mexico, 4General Hospital of Mexico, Mexico City, Mexico, 5Celgene S. de R.L. de C.V., Mexico D.F., Mexico, 6Health Solutions, Mexico City, Mexico
OBJECTIVES: Assess, from a Mexican health care perspective, the cost-effectiveness of azacitidine compared with Low-Doses of Chemotherapy (LDC) plus best supportive care (BSC) for the treatment of adult patients with intermediate-2 and high-risk MDS, who are not eligible for haematopoietic stem cell transplantation. METHODS: We developed a cost-effectiveness survival analysis model of 3 stages: MDS, AML, and death. OS and costs are extrapolated beyond three-year time horizon. Discount rate of 5% was applied. To estimate the model cycle probability transition to mortality state, survival curves were constructed for each treatment arm using individual patient-level data from Study AZA-001. Unitary cost are from public price list, and profiles for the management of MDS and AML were collected separately using a structured questionnaire. Probabilistic sensitivity analyses (PSA) were conducted by simultaneously sampling from estimated probability distributions of model parameters. RESULTS: Overall survival was projected to increase by 72.26 weeks with azacitidine. Incremental expected total costs for azacitidine compared to LDC was MXN $68,045. However, the cost of the drug therapy was lower with azacitidine. The ICER for azacitidine compared to LDC was MXN$48,932 per LYG. PSA showed that azacitidine was a highly cost-effective option in 96.49% of the simulated cases in MXN$180,000/LYG willingness-to-pay. CONCLUSIONS: Compared with LDC, azacitidine represents a cost-effective treatment alternative in patients with MDS from a Mexican perspective.
Conference/Value in Health Info
2017-05, ISPOR 2017, Boston, MA, USA
Value in Health, Vol. 20, No. 5 (May 2017)
Code
PSY19
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy, Relating Intermediate to Long-term Outcomes
Disease
Systemic Disorders/Conditions