Cost effectiveness of imatinib compared with interferon-α or hydroxycarbamide for first-line treatment of chronic myeloid leukaemia
Cost effectiveness of imatinib compared with interferon-α or hydroxycarbamide for first-line treatment of chronic myeloid leukaemia
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DOI：
10.2165/00019053-200523050-00010
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发表时间：
2005-01-01
影响因子：
4.4
通讯作者：
Stein, K
中科院分区：
文献类型：
--
作者：
Dalziel, K;Round, A;Stein, K
目的：评价伊马替尼与干扰素（IFN）-α或羟基脲（羟基脲）相比作为慢性髓性白血病一线治疗的成本效用。设计和设置：成本效用（马尔可夫）模型内设置的英国国民保健服务，并从卫生系统的角度来看，被采用。根据已发表的文献估计转移概率和相对风险。从英国国家处方集和当地医院数据库中获得药物治疗、门诊治疗、骨髓活检、放射照相、输血和住院治疗的费用。成本（f，2001-03年值）折扣为6%。生活质量（QOL）数据来自已发表的文献，折扣率为1.5%。主要的结局指标是获得的每QALY成本。沿着概率（随机）分析进行了广泛的单向敏感性分析。结果如下：与IFN α相比，伊马替尼的增量成本效果比（ICER），为F26 180/QALY增加（单因素敏感性分析范围为F19 449至F51 870），与羟基脲相比为F86 934/QALY（单向敏感性分析的范围为69 701至147 095法郎）[截至2002年12月31日，f1 = 1.691美元= 1.535欧元]。基于概率敏感性分析，与IFN（x）相比，伊马替尼50%的ICER低于每获得QALY约E31 000的阈值。与羟基胍丁胺相比，伊马替尼50%的ICER低于约E95000/QALY。结论：该模型表明，考虑到其基础数据和假设，与IFN α相比，伊马替尼可能具有适度的成本效益，但与羟基脲相比，成本效益要低得多。然而，由于缺乏长期数据，存在许多不确定性。
Objective: To evaluate the cost utility of imatinib compared with interferon (IFN)-alpha or hydroxycarbamide (hydroxyurea) for first-line treatment of chronic myeloid leukaemia. Design and Setting: A cost-utility (Markov) model within the setting of the UK NHS and viewed from a health system perspective was adopted. Transition probabilities and relative risks were estimated from published literature. Costs of drug treatment, outpatient care, bone marrow biopsies, radiography, blood transfusions and inpatient care were obtained from the British National Formulary and local hospital databases. Costs (f, year 2001-03 values) were discounted at 6%. Quality-of-life (QOL) data were obtained from the published literature and discounted at 1.5%. The main outcome measure was cost per QALY gained. Extensive one-way sensitivity analyses were performed along with probabilistic (stochastic) analysis. Results: The incremental cost-effectiveness ratio (ICER) of imatinib, compared with IFN alpha, was F26 180 per QALY gained (one-way sensitivity analyses ranged from F19 449 to F51 870) and compared with hydroxycarbamide was F86 934 per QALY (one-way sensitivity analyses ranged from F69 701 to F147 095) [f1 = $US1.691 = E1.535 as at 31 December 2002]. Based on the probabilistic sensitivity analysis, 50% of the ICERs for imatinib, compared with IFN(x, fell below a threshold of approximately E31 000 per QALY gained. Fifty percent of ICERs for imatinib, compared with hydroxygarbamide, fell below approximately E95 000 per QALY gained. Conclusions: This model suggests, given its underlying data and assumptions, that imatinib may be moderately cost effective when compared with IFN(x but considerably less cost effective when compared,with hydroxycarbamide. There are, however, many uncertainties due to the lack of long-term data.