V Babashov1, M A Begen2, J Mangel3, G S Zaric2. 1. Telfer School of Management, University of Ottawa, Ottawa, ON. 2. Ivey Business School, Western University, London, ON;; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, and. 3. Department of Medicine, Division of Hematology, Schulich School of Medicine and Dentistry, Western University, London, ON.
Abstract
BACKGROUND: We conducted a cost-effectiveness analysis of brentuximab vedotin for the treatment of relapsed and refractory Hodgkin lymphoma (hl) in the post-autologous stem-cell transplantation (asct) failure period, from the perspective of the Canadian health care payer. METHODS: We developed a decision-analytic model to simulate lifetime costs and benefits of brentuximab vedotin compared with best supportive care for the treatment of patients with hl after failure of asct. Administrative data from Ontario were used to set the model parameters. RESULTS: In the base case, treatment with brentuximab vedotin resulted in incremental quality-adjusted life-years (qalys) of 0.544 and an incremental cost of $89,366 per patient, corresponding to an incremental cost-effectiveness ratio (icer) of $164,248 per qaly gained. The icer was sensitive to the cost of brentuximab vedotin, the hazard ratio used to assess the efficacy of brentuximab vedotin treatment, and health state utilities. CONCLUSIONS: In light of the available information, brentuximab vedotin has an icer exceeding $100,000 per qaly gained, which is a level often classified as having "weak evidence for adoption and appropriate utilization" in Canada. However, it is worth noting that provincial cancer agencies take into account not only the costs and associated icer, but also other factors such as a lack of alternative treatment options and the clinical benefits of expensive cancer drugs. Pricing arrangements should be negotiated, and risk-sharing agreements or patient access schemes should be explored.
BACKGROUND: We conducted a cost-effectiveness analysis of brentuximab vedotin for the treatment of relapsed and refractory Hodgkin lymphoma (hl) in the post-autologous stem-cell transplantation (asct) failure period, from the perspective of the Canadian health care payer. METHODS: We developed a decision-analytic model to simulate lifetime costs and benefits of brentuximab vedotin compared with best supportive care for the treatment of patients with hl after failure of asct. Administrative data from Ontario were used to set the model parameters. RESULTS: In the base case, treatment with brentuximab vedotin resulted in incremental quality-adjusted life-years (qalys) of 0.544 and an incremental cost of $89,366 per patient, corresponding to an incremental cost-effectiveness ratio (icer) of $164,248 per qaly gained. The icer was sensitive to the cost of brentuximab vedotin, the hazard ratio used to assess the efficacy of brentuximab vedotin treatment, and health state utilities. CONCLUSIONS: In light of the available information, brentuximab vedotin has an icer exceeding $100,000 per qaly gained, which is a level often classified as having "weak evidence for adoption and appropriate utilization" in Canada. However, it is worth noting that provincial cancer agencies take into account not only the costs and associated icer, but also other factors such as a lack of alternative treatment options and the clinical benefits of expensive cancer drugs. Pricing arrangements should be negotiated, and risk-sharing agreements or patient access schemes should be explored.
Authors: J M Vose; P J Bierman; J R Anderson; A Kessinger; J Pierson; J Nelson; B Frappier; K Schmit-Pokorny; D D Weisenburger; J O Armitage Journal: Blood Date: 1992-10-15 Impact factor: 22.113
Authors: David E Cohn; Kenneth H Kim; Kimberly E Resnick; David M O'Malley; J Michael Straughn Journal: J Clin Oncol Date: 2011-03-07 Impact factor: 44.544
Authors: Nicole Mittmann; Heather-Jane Au; Dongsheng Tu; Christopher J O'Callaghan; Pierre K Isogai; Christos S Karapetis; John R Zalcberg; William K Evans; Malcolm J Moore; Jehan Siddiqui; Brian Findlay; Bruce Colwell; John Simes; Peter Gibbs; Matthew Links; Niall C Tebbutt; Derek J Jonker Journal: J Natl Cancer Inst Date: 2009-08-07 Impact factor: 13.506
Authors: Anas Younes; Ajay K Gopal; Scott E Smith; Stephen M Ansell; Joseph D Rosenblatt; Kerry J Savage; Radhakrishnan Ramchandren; Nancy L Bartlett; Bruce D Cheson; Sven de Vos; Andres Forero-Torres; Craig H Moskowitz; Joseph M Connors; Andreas Engert; Emily K Larsen; Dana A Kennedy; Eric L Sievers; Robert Chen Journal: J Clin Oncol Date: 2012-03-26 Impact factor: 44.544
Authors: Craig H Moskowitz; Auayporn Nademanee; Tamas Masszi; Edward Agura; Jerzy Holowiecki; Muneer H Abidi; Andy I Chen; Patrick Stiff; Alessandro M Gianni; Angelo Carella; Dzhelil Osmanov; Veronika Bachanova; John Sweetenham; Anna Sureda; Dirk Huebner; Eric L Sievers; Andy Chi; Emily K Larsen; Naomi N Hunder; Jan Walewski Journal: Lancet Date: 2015-03-19 Impact factor: 79.321
Authors: M Varterasian; V Ratanatharathorn; J P Uberti; C Karanes; E Abella; F Momin; C Kasten-Sportes; A Al-Katib; L Lum; L K Heilbrun Journal: Leuk Lymphoma Date: 1995-12
Authors: Philippe Armand; Haesook T Kim; Vincent T Ho; Corey S Cutler; John Koreth; Joseph H Antin; Ann S LaCasce; Eric D Jacobsen; David C Fisher; Jennifer R Brown; George P Canellos; Arnold S Freedman; Robert J Soiffer; Edwin P Alyea Journal: Biol Blood Marrow Transplant Date: 2008-04 Impact factor: 5.742
Authors: Gursharan K Sohi; Jordan Levy; Victoria Delibasic; Laura E Davis; Alyson L Mahar; Elmira Amirazodi; Craig C Earle; Julie Hallet; Ahmed Hammad; Rajan Shah; Nicole Mittmann; Natalie G Coburn Journal: Eur J Health Econ Date: 2021-03-09