Economic evaluation of dasatinib in the treatment of chronic myeloid leukemia patients resistant to imatinib in Chile
Objective. Within the framework of Chronic Myelogenous Leukaemia (CML) treatment in Chile, and based on a previously performed economic evaluation, we compared the costs and cost-effectiveness ratio of using 100 mg/day and 140 mg/day doses of dasatinib with the use of 800 mg/day doses of nilotinib o...
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| Format: | Article |
| Language: | English |
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Medwave Estudios Limitada
2011-04-01
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| Series: | Medwave |
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| Online Access: | http://dx.doi.org/10.5867/medwave.2011.04.5012 |
| _version_ | 1818347433997893632 |
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| author | Milva Caputo Eleonora Aiello Juan Esteban Valencia John Jairo Orozco Giraldo |
| author_facet | Milva Caputo Eleonora Aiello Juan Esteban Valencia John Jairo Orozco Giraldo |
| author_sort | Milva Caputo |
| collection | DOAJ |
| description | Objective. Within the framework of Chronic Myelogenous Leukaemia (CML) treatment in Chile, and based on a previously performed economic evaluation, we compared the costs and cost-effectiveness ratio of using 100 mg/day and 140 mg/day doses of dasatinib with the use of 800 mg/day doses of nilotinib or an increased dose of imatinib (800mg/day), for each phase of the disease, in patients who developed resistance or intolerance to habitual doses of imatinib. Methods. A Markov model was used for this economic evaluation, which considered a cohort of 10.000 CML patients in its three phases (chronic, accelerated or blast phase), a lifetime horizon and a 3.5 % discount rate for costs and benefits. Model results included the costs of each treatment alternative with dasatinib, nilotinib or imatinib, and Quality Adjusted Life Years (QALYs) gained. Costs were measured in Chilean Pesos of year 2010. Results. In the chronic phase of the disease, dasatinib 100 mg/day yielded the higher amount of QALYs with 6,65 and the lower cost-effectiveness ratio. In the accelerated phase, dasatinib 140 mg/day also showed the lowest cost-effectiveness compared to nilotinib and imatinib. In the blast phase, dasatinib showed lower cost-effectiveness ratio than imatinib. Conclusions. Dasatinib 100 mg/day showed lowest cost-effectiveness ratios than doses of 800 mg/day of nilotinib and doses of 800 mg/day of imatinib for the treatment of patients with CML resistant or intolerant to the usual imatinib doses of 400 mg/day in the chronic phase. Dasatinib 140 mg/day showed lowest cost-effectiveness ratios than doses of 800 mg/day of nilotinib and 800 mg/day of imatinib for the treatment of patients with CML in the accelerated phase, and than doses of 800 mg/day of imatinib in blast phase. Although there was an overall cost increase, especially due to the cost of dasatinib in 140 mg/day doses, this fact was explained by the increase in life years gained and, consequently, the use of medical resources and drugs. |
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| format | Article |
| id | doaj.art-7cc398299c5847d8a44fa145c99f31eb |
| institution | Directory Open Access Journal |
| issn | 0717-6384 |
| language | English |
| last_indexed | 2024-12-13T17:34:06Z |
| publishDate | 2011-04-01 |
| publisher | Medwave Estudios Limitada |
| record_format | Article |
| series | Medwave |
| spelling | doaj.art-7cc398299c5847d8a44fa145c99f31eb2022-12-21T23:36:58ZengMedwave Estudios LimitadaMedwave0717-63842011-04-011104e5012Economic evaluation of dasatinib in the treatment of chronic myeloid leukemia patients resistant to imatinib in ChileMilva CaputoEleonora AielloJuan Esteban ValenciaJohn Jairo Orozco GiraldoObjective. Within the framework of Chronic Myelogenous Leukaemia (CML) treatment in Chile, and based on a previously performed economic evaluation, we compared the costs and cost-effectiveness ratio of using 100 mg/day and 140 mg/day doses of dasatinib with the use of 800 mg/day doses of nilotinib or an increased dose of imatinib (800mg/day), for each phase of the disease, in patients who developed resistance or intolerance to habitual doses of imatinib. Methods. A Markov model was used for this economic evaluation, which considered a cohort of 10.000 CML patients in its three phases (chronic, accelerated or blast phase), a lifetime horizon and a 3.5 % discount rate for costs and benefits. Model results included the costs of each treatment alternative with dasatinib, nilotinib or imatinib, and Quality Adjusted Life Years (QALYs) gained. Costs were measured in Chilean Pesos of year 2010. Results. In the chronic phase of the disease, dasatinib 100 mg/day yielded the higher amount of QALYs with 6,65 and the lower cost-effectiveness ratio. In the accelerated phase, dasatinib 140 mg/day also showed the lowest cost-effectiveness compared to nilotinib and imatinib. In the blast phase, dasatinib showed lower cost-effectiveness ratio than imatinib. Conclusions. Dasatinib 100 mg/day showed lowest cost-effectiveness ratios than doses of 800 mg/day of nilotinib and doses of 800 mg/day of imatinib for the treatment of patients with CML resistant or intolerant to the usual imatinib doses of 400 mg/day in the chronic phase. Dasatinib 140 mg/day showed lowest cost-effectiveness ratios than doses of 800 mg/day of nilotinib and 800 mg/day of imatinib for the treatment of patients with CML in the accelerated phase, and than doses of 800 mg/day of imatinib in blast phase. Although there was an overall cost increase, especially due to the cost of dasatinib in 140 mg/day doses, this fact was explained by the increase in life years gained and, consequently, the use of medical resources and drugs.http://dx.doi.org/10.5867/medwave.2011.04.5012Leukemia Myelogenousimatinibdasatinibnilotinibcost effectivenessresistance |
| spellingShingle | Milva Caputo Eleonora Aiello Juan Esteban Valencia John Jairo Orozco Giraldo Economic evaluation of dasatinib in the treatment of chronic myeloid leukemia patients resistant to imatinib in Chile Medwave Leukemia Myelogenous imatinib dasatinib nilotinib cost effectiveness resistance |
| title | Economic evaluation of dasatinib in the treatment of chronic myeloid leukemia patients resistant to imatinib in Chile |
| title_full | Economic evaluation of dasatinib in the treatment of chronic myeloid leukemia patients resistant to imatinib in Chile |
| title_fullStr | Economic evaluation of dasatinib in the treatment of chronic myeloid leukemia patients resistant to imatinib in Chile |
| title_full_unstemmed | Economic evaluation of dasatinib in the treatment of chronic myeloid leukemia patients resistant to imatinib in Chile |
| title_short | Economic evaluation of dasatinib in the treatment of chronic myeloid leukemia patients resistant to imatinib in Chile |
| title_sort | economic evaluation of dasatinib in the treatment of chronic myeloid leukemia patients resistant to imatinib in chile |
| topic | Leukemia Myelogenous imatinib dasatinib nilotinib cost effectiveness resistance |
| url | http://dx.doi.org/10.5867/medwave.2011.04.5012 |
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