Simon Frey1, Carl R Blankart1,2, Tom Stargardt3. 1. Hamburg Center for Health Economics, Universität Hamburg, Esplanade 36, 20354, Hamburg, Germany. 2. Center for Gerontology and Health Care Research, School of Public Health, Brown University, Providence, RI, USA. 3. Hamburg Center for Health Economics, Universität Hamburg, Esplanade 36, 20354, Hamburg, Germany. tom.stargardt@wiso.uni-hamburg.de.
Abstract
BACKGROUND: Chronic lymphocytic leukemia (CLL) is the most prevalent type of leukemia in the Western hemisphere. The disease affects quality of life (QOL) and poses an economic burden on patients, payers, and society. The objective of this review was to quantify the economic burden and quality-of-life effects and identify the gaps that should be addressed by future research. METHODS: Free-text and subject heading searches in MEDLINE, EMBASE, the Cochrane Library, the University of York Centre for Reviews and Dissemination Database, and the Web of Science Core Collection database were conducted to identify observational and interventional studies reporting costs and/or quality-of-life effects published up to 2 October 2015. Studies were included irrespective of whether they were conducted prospectively or retrospectively. The focus population consisted of adult patients aged 18 years or older affected by any stage of CLL. Studies were included regardless of whether the underlying population was treated at baseline or not. Risk of bias was assessed using a quality checklist developed by the Effective Public Health Practice Project for (randomized) controlled trials, cohort studies, and cross-sectional studies. Economic evaluations were rated using a checklist developed by Stuhldreher et al. (Int J Eat Disord 45:476-91, 2012). RESULTS: From 2451 records identified, 27 studies were found to be eligible for inclusion. Studies were heterogeneous with respect to methodology, perspective, and data used. Annual direct costs per person ranged from US$4491 in Germany to US$43,913 in the USA. The share of costs attributable to drug treatment varied between 26.2 and 79 %. Indirect costs amounted to US$4208. Severity of disease was a predictor for quality of life, whereas differences by age and sex were mainly present in subdomains. Comparisons of treated and untreated populations resulted in an increase of quality of life in favor of treated populations in the long-term perspective. Differences between treatments were small. Consequently, cost effectiveness in decision-analytic models did not depend on whether quality of life or survival are used to describe the benefits of treatment. CONCLUSIONS: Although the quantity and the quality of health economic and quality-of-life evidence have substantially increased, there is still a need for studies that take a patient or societal perspective. Factors that influence costs and the quality of life of patients seem to be well-established, while longitudinal lifetime cost studies at the population level are still scarce.
BACKGROUND:Chronic lymphocytic leukemia (CLL) is the most prevalent type of leukemia in the Western hemisphere. The disease affects quality of life (QOL) and poses an economic burden on patients, payers, and society. The objective of this review was to quantify the economic burden and quality-of-life effects and identify the gaps that should be addressed by future research. METHODS: Free-text and subject heading searches in MEDLINE, EMBASE, the Cochrane Library, the University of York Centre for Reviews and Dissemination Database, and the Web of Science Core Collection database were conducted to identify observational and interventional studies reporting costs and/or quality-of-life effects published up to 2 October 2015. Studies were included irrespective of whether they were conducted prospectively or retrospectively. The focus population consisted of adult patients aged 18 years or older affected by any stage of CLL. Studies were included regardless of whether the underlying population was treated at baseline or not. Risk of bias was assessed using a quality checklist developed by the Effective Public Health Practice Project for (randomized) controlled trials, cohort studies, and cross-sectional studies. Economic evaluations were rated using a checklist developed by Stuhldreher et al. (Int J Eat Disord 45:476-91, 2012). RESULTS: From 2451 records identified, 27 studies were found to be eligible for inclusion. Studies were heterogeneous with respect to methodology, perspective, and data used. Annual direct costs per person ranged from US$4491 in Germany to US$43,913 in the USA. The share of costs attributable to drug treatment varied between 26.2 and 79 %. Indirect costs amounted to US$4208. Severity of disease was a predictor for quality of life, whereas differences by age and sex were mainly present in subdomains. Comparisons of treated and untreated populations resulted in an increase of quality of life in favor of treated populations in the long-term perspective. Differences between treatments were small. Consequently, cost effectiveness in decision-analytic models did not depend on whether quality of life or survival are used to describe the benefits of treatment. CONCLUSIONS: Although the quantity and the quality of health economic and quality-of-life evidence have substantially increased, there is still a need for studies that take a patient or societal perspective. Factors that influence costs and the quality of life of patients seem to be well-established, while longitudinal lifetime cost studies at the population level are still scarce.
Authors: S Walker; S Palmer; S Erhorn; S Brent; A Dyker; L Ferrie; W Horsley; K Macfarlane; S White; S Thomas Journal: Health Technol Assess Date: 2009-06 Impact factor: 4.014
Authors: Don Husereau; Michael Drummond; Stavros Petrou; Chris Carswell; David Moher; Dan Greenberg; Federico Augustovski; Andrew H Briggs; Josephine Mauskopf; Elizabeth Loder Journal: Value Health Date: 2013 Mar-Apr Impact factor: 5.725
Authors: Michael Adena; Jennifer Houltram; Stephen P Mulligan; Carlene Todd; Grace Malanos Journal: Pharmacoeconomics Date: 2014-02 Impact factor: 4.981
Authors: Stephen P Mulligan; Karin Karlsson; Mats Strömberg; Viggo Jønsson; Devinder Gill; Jens Hammerström; Mark Hertzberg; Roger McLennan; Bertil Uggla; John Norman; Jonas Wallvik; Gunnel Sundström; Hemming Johansson; Yvonne Brandberg; Jan Liliemark; Gunnar Juliusson Journal: Leuk Lymphoma Date: 2014-04-16
Authors: Esther C van den Broek; Simone Oerlemans; Marten R Nijziel; Eduardus F M Posthuma; Jan Willem W Coebergh; Lonneke V van de Poll-Franse Journal: Ann Hematol Date: 2014-07-20 Impact factor: 3.673
Authors: Liesbeth C de Wreede; Maggie Watson; Marleen van Os; Donald Milligan; Michel van Gelder; Mauricette Michallet; Peter Dreger; Claire E Dearden; Janis Homewood; Jehan Dupuis; Michel Leporrier; Michal Karas; Bernadette Corront; Gabriela M Baerlocher; Wolfgang Herr; Sylvain Choquet; Dietger W Niederwieser; Laurent Sutton; Nicolaus Kröger; Theo M de Witte; Johannes Schetelig On Behalf Of The Chronic Malignancies Working Party Of The Ebmt And The Uk Medical Research Council Journal: Am J Hematol Date: 2014-02 Impact factor: 10.047
Authors: K M Holtzer-Goor; M R Schaafsma; P Joosten; E F M Posthuma; S Wittebol; P C Huijgens; E J M Mattijssen; G Vreugdenhil; H Visser; W G Peters; Z Erjavec; P W Wijermans; S M G J Daenen; K G van der Hem; M H J van Oers; C A Uyl-de Groot Journal: Qual Life Res Date: 2015-07-24 Impact factor: 4.147
Authors: D Catovsky; S Richards; E Matutes; D Oscier; Mjs Dyer; R F Bezares; A R Pettitt; T Hamblin; D W Milligan; J A Child; M S Hamilton; C E Dearden; A G Smith; A G Bosanquet; Z Davis; V Brito-Babapulle; M Else; R Wade; P Hillmen Journal: Lancet Date: 2007-07-21 Impact factor: 79.321
Authors: James Buchanan; Sarah Wordsworth; Ruth Clifford; Pauline Robbe; Jenny C Taylor; Anna Schuh; Samantha J L Knight Journal: Pharmacoeconomics Date: 2017-08 Impact factor: 4.981