Cost-effectiveness analysis of imatinib versus dasatinib in the treatment of pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia when combined with conventional chemotherapy in China
Abstract Background Tyrosine kinase inhibitors combined with conventional chemotherapy (CC) in treating Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-positive ALL) has achieved promising efficacy and safety outcomes. The study was conducted to compare the cost-effectiveness betwe...
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BMC
2023-06-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-023-09600-7 |
| _version_ | 1797795784149696512 |
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| author | Min Chen Lulu Liu Lingli Zhang Yunzhu Lin Xiaoxi Lu Hao Yang Jiaqi Ni |
| author_facet | Min Chen Lulu Liu Lingli Zhang Yunzhu Lin Xiaoxi Lu Hao Yang Jiaqi Ni |
| author_sort | Min Chen |
| collection | DOAJ |
| description | Abstract Background Tyrosine kinase inhibitors combined with conventional chemotherapy (CC) in treating Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-positive ALL) has achieved promising efficacy and safety outcomes. The study was conducted to compare the cost-effectiveness between imatinib (HANSOH Pharma, Jiangsu, China) and dasatinib (CHIATAI TIANQING Pharma, Jiangsu, China) in treating pediatric Ph-positive ALL when combined with CC from the perspective of the health system in China. Methods A Markov model was established to simulate a hypothetical cohort of pediatric Ph-positive ALL patients receiving imatinib or dasatinib, combined with CC. The model was designed using a 10-year horizon, a 3- month cycle, and a 5% discount rate. Three health states were included: alive with progression-free survival, progressed disease, and death. Patient characteristics and transition probabilities were estimated based on clinical trials. Other relevant data, such as direct treatment costs and health utility data were extracted from published literature and Sichuan Province’s centralized procurement and supervision platform. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to assess the robustness of the results. The willingness-to-pay (WTP) was set as three times China’s GDP per capita in 2021. Results In the base-case analysis, the total medical costs were $89,701 and $101,182, and the quality-adjusted life years (QALYs) gained were 1.99 and 2.70, for imatinib and dasatinib regimens, respectively. The incremental cost-effectiveness ratio for dasatinib versus imatinib was $16,170/QALY. The probabilistic sensitivity analysis indicated that treatment with dasatinib combined with CC achieved a 96.4% probability of cost-effectiveness at a WTP threshold of $37,765/QALY. Conclusions Dasatinib combined with CC is likely to be a cost-effective strategy compared to imatinib combination therapy for pediatric Ph-positive ALL in China at a WTP threshold of $37,765/QALY. |
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| language | English |
| last_indexed | 2024-03-13T03:23:15Z |
| publishDate | 2023-06-01 |
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| series | BMC Health Services Research |
| spelling | doaj.art-7a11ca200c3e455aa3fb992ae4ea798e2023-06-25T11:12:50ZengBMCBMC Health Services Research1472-69632023-06-012311910.1186/s12913-023-09600-7Cost-effectiveness analysis of imatinib versus dasatinib in the treatment of pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia when combined with conventional chemotherapy in ChinaMin Chen0Lulu Liu1Lingli Zhang2Yunzhu Lin3Xiaoxi Lu4Hao Yang5Jiaqi Ni6Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan UniversitySchool of Pharmaceutical Science and Technology, Tianjin UniversityDepartment of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan UniversityDepartment of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan UniversityKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of EducationWest China School of Pharmacy, Sichuan UniversityDepartment of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan UniversityAbstract Background Tyrosine kinase inhibitors combined with conventional chemotherapy (CC) in treating Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-positive ALL) has achieved promising efficacy and safety outcomes. The study was conducted to compare the cost-effectiveness between imatinib (HANSOH Pharma, Jiangsu, China) and dasatinib (CHIATAI TIANQING Pharma, Jiangsu, China) in treating pediatric Ph-positive ALL when combined with CC from the perspective of the health system in China. Methods A Markov model was established to simulate a hypothetical cohort of pediatric Ph-positive ALL patients receiving imatinib or dasatinib, combined with CC. The model was designed using a 10-year horizon, a 3- month cycle, and a 5% discount rate. Three health states were included: alive with progression-free survival, progressed disease, and death. Patient characteristics and transition probabilities were estimated based on clinical trials. Other relevant data, such as direct treatment costs and health utility data were extracted from published literature and Sichuan Province’s centralized procurement and supervision platform. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to assess the robustness of the results. The willingness-to-pay (WTP) was set as three times China’s GDP per capita in 2021. Results In the base-case analysis, the total medical costs were $89,701 and $101,182, and the quality-adjusted life years (QALYs) gained were 1.99 and 2.70, for imatinib and dasatinib regimens, respectively. The incremental cost-effectiveness ratio for dasatinib versus imatinib was $16,170/QALY. The probabilistic sensitivity analysis indicated that treatment with dasatinib combined with CC achieved a 96.4% probability of cost-effectiveness at a WTP threshold of $37,765/QALY. Conclusions Dasatinib combined with CC is likely to be a cost-effective strategy compared to imatinib combination therapy for pediatric Ph-positive ALL in China at a WTP threshold of $37,765/QALY.https://doi.org/10.1186/s12913-023-09600-7ImatinibDasatinibCost-effectiveness analysisPhiladelphia chromosome-positiveAcute lymphoblastic leukemia |
| spellingShingle | Min Chen Lulu Liu Lingli Zhang Yunzhu Lin Xiaoxi Lu Hao Yang Jiaqi Ni Cost-effectiveness analysis of imatinib versus dasatinib in the treatment of pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia when combined with conventional chemotherapy in China BMC Health Services Research Imatinib Dasatinib Cost-effectiveness analysis Philadelphia chromosome-positive Acute lymphoblastic leukemia |
| title | Cost-effectiveness analysis of imatinib versus dasatinib in the treatment of pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia when combined with conventional chemotherapy in China |
| title_full | Cost-effectiveness analysis of imatinib versus dasatinib in the treatment of pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia when combined with conventional chemotherapy in China |
| title_fullStr | Cost-effectiveness analysis of imatinib versus dasatinib in the treatment of pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia when combined with conventional chemotherapy in China |
| title_full_unstemmed | Cost-effectiveness analysis of imatinib versus dasatinib in the treatment of pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia when combined with conventional chemotherapy in China |
| title_short | Cost-effectiveness analysis of imatinib versus dasatinib in the treatment of pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia when combined with conventional chemotherapy in China |
| title_sort | cost effectiveness analysis of imatinib versus dasatinib in the treatment of pediatric philadelphia chromosome positive acute lymphoblastic leukemia when combined with conventional chemotherapy in china |
| topic | Imatinib Dasatinib Cost-effectiveness analysis Philadelphia chromosome-positive Acute lymphoblastic leukemia |
| url | https://doi.org/10.1186/s12913-023-09600-7 |
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