Cost Effectiveness of Rituximab Maintenance Therapy in Follicular Lymphoma Long-Term Economic Evaluation
Fiche publication
Date publication
janvier 2010
Auteurs
Membres identifiés du Cancéropôle Est :
Pr DECONINCK Eric
Tous les auteurs :
Deconinck E, Miadi-Fargier H, Le Pen C, Brice P
Lien Pubmed
Résumé
Background: Rituximab maintenance therapy was shown to significantly extend overall survival (OS) and progression-free survival (PFS) in relapsed/refractory follicular lymphoma (FL) in the pivotal EORTC 20981 trial. Objective: To assess the long-term costs and cost effectiveness of rituximab maintenance therapy after induction therapy versus current standard practice (observation) from the French National Health Service perspective. Methods: A lifetime transition model was developed comparing rituximab maintenance with observation PFS and OS were obtained from the EORTC 20981 trial with a median follow-up of 28 months and extrapolated from 2-year Kaplan-Meier curves using a Weibull distribution PFS and OS benefits of rituximab were conservatively assumed to last only 5 years. Utility data were obtained from a multicentre observational Study using the EQ-5D questionnaire Direct medical costs were obtained from French official sources. All costs are reported in E., year 2006 values. Results: The EORTC 20981 study demonstrated that rituximab maintenance was effective in the management of relapsed/refractory FL. The model results showed that life expectancy and QALYs were increased by 22% and 28%. respectively, in patients treated with rituximab. The incremental cost-effectiveness ratios (ICERs) were (sic)7612 per life-year gained and (sic)8729 per QALY gained In a one-way sensitivity analysis, most of the ICERs fell within the range of (sic)7000-12000. Conclusion: The results tend to show that rituximab maintenance therapy may be a cost-effective strategy in the management of relapsed/refractory FL ill France, with ICERs below those observed for other therapies in the oncology Field The cost of rituximab was partly offset by the lower cost of relapse due to a longer time in the disease-free health state For patients ill the rituximab arm.
Référence
Pharmacoeconomics. 2010;28(1):35-46