COST-EFFECTIVENESS OF BRENTUXIMAB VEDOTIN IN RELAPSED OR REFRACTORY HODGKIN'S LYMPHOMA FOLLOWING AUTOLOGOUS STEM CELL TRANSPLANT IN TAIWAN

Author(s)

Zou D1, Kendall R1, Lin Q2, Huang Y2, Tieng J3, Tseng J3, Sajosi P4
1ICON plc, Vancouver, BC, Canada, 2Kantar Health, Taipei, Taiwan, 3Takeda Pharmaceuticals Taiwan, Taipei, Taiwan, 4Takeda Pharmaceuticals International AG, Zurich, Switzerland

OBJECTIVES: To assess the cost-effectiveness of brentuximab vedotin (BV) compared to conventional chemotherapy in patients with Hodgkin’s lymphoma (HL) relapsing following an autologous stem cell transplant (ASCT) and prior chemotherapy with curative intent in Taiwan. METHODS: A lifetime partitioned survival model with three health states (progression-free/post-progression/death) was developed. Clinical effectiveness of BV was obtained from a phase II, single-arm trial where 102 patients with relapsing/refractory HL post-ASCT were enrolled. The survival following conventional chemotherapy and subsequent allogeneic SCT was based on best available published data from two European registries. Beyond the trial period BV was assumed to have the same risk of progression or death as the comparator. A perspective of the Taiwanese National Health Insurance Administration was adopted and costs (in 2015 New Taiwan dollars [NT$]) included direct medical costs such as physician services, hospital services, and outpatient care. Utilities of health states and disutilities of adverse events were sourced from the literature, and used to calculate quality-adjusted life years (QALYs). Deterministic and probabilistic sensitivity analyses were conducted to explore uncertainty around incremental cost/QALY gained. RESULTS: Compared to conventional chemotherapy, BV provided an additional 0.98 QALYs over modelled lifetime due to a prolonged progression-free interval (3.69 vs. 1.87 undiscounted life years). BV was associated with an additional cost of NT$1,648,000. The estimated incremental cost/QALY was approximately NT$1,683,200. At a willingness-to-pay of NT$2,184,300 (triple value of Taiwan GDP), the probability that BV is cost-effective is 72%. Deterministic sensitivity analyses suggested BV’s cost-effectiveness was most sensitive to shorter time horizon, inclusion of BV vial wastage, and BV response rates, but was robust to the choice of parametric distributions fit to the Kaplan-Meier curves for survival functions. CONCLUSIONS: The current economic evaluation supports BV being a cost-effective addition to the management of patients with relapsing/refractory HL in the Taiwanese health care setting.

Conference/Value in Health Info

2016-09, ISPOR Asia Pacific 2016, Singapore

Value in Health, Vol. 19, No. 7 (November 2016)

Code

PCN24

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Oncology

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