Cost-effectiveness analysis of bendamustine plus rituximab as a first-line treatment for patients with follicular lymphoma in Spain.

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• dc.contributor.author Sabater, Eliazarca
• dc.contributor.author López Guillermo, Armandoca
• dc.contributor.author Rueda, Antonioca
• dc.contributor.author Salar Silvestre, Antonioca
• dc.contributor.author Oyagüez, Itziarca
• dc.contributor.author Collar, Juan Manuelca
• dc.date.accessioned 2016-07-25T11:46:38Z
• dc.date.issued 2016
• dc.description.abstract BACKGROUND: Follicular lymphoma (FL) is the second most common type of lymphoid cancer in Western Europe. OBJECTIVE: The aim of this study was to evaluate the cost utility of rituximab-bendamustine treatment compared with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) treatment as a first-line therapy for patients with advanced FL in Spain. METHODS: A Markov model was developed to estimate the cost effectiveness of rituximab-bendamustine compared with R-CHOP as first-line treatment for patients with advanced FL in the Spanish National Health System (NHS). Transitions between health states (progression-free, including induction and maintenance; first relapse; second relapse; and death) were allowed for the patient cohort in 4-week-long cycles. Clinical data for the extrapolation of progression-free survival curves were obtained from randomized trials. Mortality rates and utilities were obtained from the literature. Outcomes were measured as quality-adjusted life-years (QALYs). The total costs (€, 2013) included drug costs (ex-factory prices with mandatory deductions), disease management costs and adverse event-associated costs. Costs and outcomes were discounted at a 3 % annual rate. Probabilistic sensitivity analysis was performed using 10,000 Monte Carlo simulations to assess the model robustness. RESULTS: Treatment and administration costs during the induction phase were higher for rituximab-bendamustine (€17,671) than for R-CHOP (€11,850). At the end of the 25-year period, the rituximab-bendamustine first-line strategy had a total cost of €68,357 compared with €69,528 for R-CHOP. Health benefits were higher for rituximab-bendamustine treatment (10.31 QALYs) than for R-CHOP treatment (9.82 QALYs). In the probabilistic analysis, rituximab-bendamustine was the dominant strategy over treatment with R-CHOP in 53.4 % of the simulations. CONCLUSION: First-line therapy with rituximab-bendamustine in FL patients was the dominant strategy over treatment with R-CHOP; it showed cost savings and higher health benefits for the Spanish NHS.ca
• dc.description.sponsorship This work was performed thanks to financial support from Mundipharma Pharmaceuticals, S.L. (Spain). ES and IO are employed by PORIB, a consultant company specialized in health economic evaluations. JMC is employed by Mundipharma Pharmaceuticals. AR has received honoraria from Mundipharma Pharmaceuticals, for advocacy tasks related to the presentwork and investigational funds and lecture honoraria from Roche Pharma. AS and ALG have received honoraria from Mundipharma Pharmaceuticals, for advocacy tasks related to the present work.
• dc.format.mimetype application/pdfca
• dc.identifier.citation Sabater E, López-Guillermo A, Rueda A, Salar A, Oyagüez I, Collar JM. Cost-effectiveness analysis of bendamustine plus rituximab as a first-line treatment for patients with follicular lymphoma in Spain. Appl Health Econ Health Policy. 2016;14:465-77. DOI: 10.1007/s40258-016-0243-4ca
• dc.identifier.doi http://dx.doi.org/10.1007/s40258-016-0243-4
• dc.identifier.issn 1175-5652
• dc.identifier.uri http://hdl.handle.net/10230/27114
• dc.language.iso engca
• dc.publisher Springerca
• dc.relation.ispartof Applied Health Economics and Health Policy. 2016;14:465-77
• dc.rights © Springer The final publication is available at Springer via http://dx.doi.org/10.1007/s40258-016-0243-4ca
• dc.rights.accessRights info:eu-repo/semantics/openAccessca
• dc.subject.other Limfomes -- Tractament -- Espanyaca
• dc.subject.other Càncer -- Tractamentca
• dc.title Cost-effectiveness analysis of bendamustine plus rituximab as a first-line treatment for patients with follicular lymphoma in Spain.ca
• dc.type info:eu-repo/semantics/articleca
• dc.type.version info:eu-repo/semantics/acceptedVersionca