Ibrutinib versus bendamustine plus rituximab for first-line treatment of 65 or older patients with untreated chronic lymphocytic leukemia without del(17p)/TP53 mutation in China: a lifetime economic research study
Abstract Background The incidence and mortality rates of patients with chronic lymphocytic leukemia (CLL) in China have recently increased. This study performed a long-term economic evaluation of the first-line treatment strategies ibrutinib (IB) or bendamustine (BE) plus rituximab (RI) for previous...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-023-10402-0 |
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| author | Yuan Hong Xichuang Chen Yuanquan Hong Xingfang Xiao Yan Wang Xiaohong You Jingyi Mi Tao Zhou Panpan Zheng Zhihu Huang |
| author_facet | Yuan Hong Xichuang Chen Yuanquan Hong Xingfang Xiao Yan Wang Xiaohong You Jingyi Mi Tao Zhou Panpan Zheng Zhihu Huang |
| author_sort | Yuan Hong |
| collection | DOAJ |
| description | Abstract Background The incidence and mortality rates of patients with chronic lymphocytic leukemia (CLL) in China have recently increased. This study performed a long-term economic evaluation of the first-line treatment strategies ibrutinib (IB) or bendamustine (BE) plus rituximab (RI) for previously untreated older patients with CLL without the del(17p)/TP53 mutation in China. Methods Based on clinical data from large, randomized trials, a Markov model including four disease states (event-free survival, treatment failure, post-treatment failure, and death) was used to estimate the incremental costs per quality adjusted-life year (QALY) gained from the first-line IB strategy versus the BE plus RI strategy over a 10-year period. All costs were adjusted to 2022 values based on the Chinese Consumer Price Index, and all costs and health outcomes were discounted at an annual rate of 5%. Sensitivity analysis was performed to confirm the robustness of base-case results. Results Compared to the first-line BE plus RI strategy, first-line IB treatment achieved 1.17 additional QALYs, but was accompanied by $88,046.78 (estimated in 2022 US dollars) in decremental costs per patient over 10 years. Thus, first-line treatment with IB appeared to have absolute dominance compared to the BE plus RI strategy. Sensitivity analysis confirmed the robustness of these results. Conclusions The first-line treatment with IB is absolutely cost-effective compared to the first-line BE plus RI treatment strategy for 65 or older patients with CLL without the del (17p)/TP53 mutation from the Chinese payer perspective. Therefore, it is strongly recommended that Chinese health authorities select the former strategy for these CLL patients. |
| first_indexed | 2024-03-09T01:20:11Z |
| format | Article |
| id | doaj.art-17ae7bffc8c947c18f23bc7de604cfc7 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-09T01:20:11Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-17ae7bffc8c947c18f23bc7de604cfc72023-12-10T12:12:35ZengBMCBMC Health Services Research1472-69632023-12-0123111110.1186/s12913-023-10402-0Ibrutinib versus bendamustine plus rituximab for first-line treatment of 65 or older patients with untreated chronic lymphocytic leukemia without del(17p)/TP53 mutation in China: a lifetime economic research studyYuan Hong0Xichuang Chen1Yuanquan Hong2Xingfang Xiao3Yan Wang4Xiaohong You5Jingyi Mi6Tao Zhou7Panpan Zheng8Zhihu Huang9Department of Pharmacy, Affiliated Children’s Hospital of Jiangnan University (Wuxi Children’s Hospital)Department of Pharmacy, Wuxi Ninth People’s Hospital Affiliated to Soochow University (Wuxi Orthopedic Hospital)Department of Pharmacy, Wuxi Ninth People’s Hospital Affiliated to Soochow University (Wuxi Orthopedic Hospital)Department of Pharmacy, Wuxi Ninth People’s Hospital Affiliated to Soochow University (Wuxi Orthopedic Hospital)Department of Pharmacy, Affiliated Children’s Hospital of Jiangnan University (Wuxi Children’s Hospital)Department of Pharmacy, Wuxi Ninth People’s Hospital Affiliated to Soochow University (Wuxi Orthopedic Hospital)Department of Sports Medicine, Wuxi Ninth People’s Hospital Affiliated to Soochow University (Wuxi Orthopedic Hospital)Department of Pharmacy, Wuxi Ninth People’s Hospital Affiliated to Soochow University (Wuxi Orthopedic Hospital)Department of PharmacyDepartment of Oncology, Wuxi Ninth People’s Hospital Affiliated to Soochow University (Wuxi Orthopedic Hospital)Abstract Background The incidence and mortality rates of patients with chronic lymphocytic leukemia (CLL) in China have recently increased. This study performed a long-term economic evaluation of the first-line treatment strategies ibrutinib (IB) or bendamustine (BE) plus rituximab (RI) for previously untreated older patients with CLL without the del(17p)/TP53 mutation in China. Methods Based on clinical data from large, randomized trials, a Markov model including four disease states (event-free survival, treatment failure, post-treatment failure, and death) was used to estimate the incremental costs per quality adjusted-life year (QALY) gained from the first-line IB strategy versus the BE plus RI strategy over a 10-year period. All costs were adjusted to 2022 values based on the Chinese Consumer Price Index, and all costs and health outcomes were discounted at an annual rate of 5%. Sensitivity analysis was performed to confirm the robustness of base-case results. Results Compared to the first-line BE plus RI strategy, first-line IB treatment achieved 1.17 additional QALYs, but was accompanied by $88,046.78 (estimated in 2022 US dollars) in decremental costs per patient over 10 years. Thus, first-line treatment with IB appeared to have absolute dominance compared to the BE plus RI strategy. Sensitivity analysis confirmed the robustness of these results. Conclusions The first-line treatment with IB is absolutely cost-effective compared to the first-line BE plus RI treatment strategy for 65 or older patients with CLL without the del (17p)/TP53 mutation from the Chinese payer perspective. Therefore, it is strongly recommended that Chinese health authorities select the former strategy for these CLL patients.https://doi.org/10.1186/s12913-023-10402-0Chronic lymphocytic leukemiaCost effectivenessIbrutinibBendamustineRituximabQuality adjusted life-year |
| spellingShingle | Yuan Hong Xichuang Chen Yuanquan Hong Xingfang Xiao Yan Wang Xiaohong You Jingyi Mi Tao Zhou Panpan Zheng Zhihu Huang Ibrutinib versus bendamustine plus rituximab for first-line treatment of 65 or older patients with untreated chronic lymphocytic leukemia without del(17p)/TP53 mutation in China: a lifetime economic research study BMC Health Services Research Chronic lymphocytic leukemia Cost effectiveness Ibrutinib Bendamustine Rituximab Quality adjusted life-year |
| title | Ibrutinib versus bendamustine plus rituximab for first-line treatment of 65 or older patients with untreated chronic lymphocytic leukemia without del(17p)/TP53 mutation in China: a lifetime economic research study |
| title_full | Ibrutinib versus bendamustine plus rituximab for first-line treatment of 65 or older patients with untreated chronic lymphocytic leukemia without del(17p)/TP53 mutation in China: a lifetime economic research study |
| title_fullStr | Ibrutinib versus bendamustine plus rituximab for first-line treatment of 65 or older patients with untreated chronic lymphocytic leukemia without del(17p)/TP53 mutation in China: a lifetime economic research study |
| title_full_unstemmed | Ibrutinib versus bendamustine plus rituximab for first-line treatment of 65 or older patients with untreated chronic lymphocytic leukemia without del(17p)/TP53 mutation in China: a lifetime economic research study |
| title_short | Ibrutinib versus bendamustine plus rituximab for first-line treatment of 65 or older patients with untreated chronic lymphocytic leukemia without del(17p)/TP53 mutation in China: a lifetime economic research study |
| title_sort | ibrutinib versus bendamustine plus rituximab for first line treatment of 65 or older patients with untreated chronic lymphocytic leukemia without del 17p tp53 mutation in china a lifetime economic research study |
| topic | Chronic lymphocytic leukemia Cost effectiveness Ibrutinib Bendamustine Rituximab Quality adjusted life-year |
| url | https://doi.org/10.1186/s12913-023-10402-0 |
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