Laura Hörster1, Richard F Schlenk2, Michael Stadler3, Maria Gabriel3, Felicitas Thol3, Jan Schildmann4, Jochen Vollmann5, Ursula Rochau6, Gaby Sroczynski7, Jürgen Wasem8, Arnold Ganser3, Matthias Port9, Anja Neumann8. 1. Institute for Health Care Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127 Essen, Germany. Electronic address: laura.hoerster@medman.uni-due.de. 2. Department of Internal Medicine III, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany. 3. Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany. 4. Dept. of Ethics and Philosophy, Wilhelm Löhe Hochschule, Merkurstraße 41/Südstadtpark 90763 Fürth, Germany; Dept. of Internal Medicine III, University Hospital Grosshadern, Ludwig Maximilians University, Marchioninistraße 15, 81377 München, Germany. 5. Institute for Medical Ethics and History of Medicine, Ruhr-Universität Bochum, Malakowturm, Markstraße 258a, 44799 Bochum, Germany. 6. Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnöfer-Zentrum 1, 6060 Hall i.T., Austria; Area 4 Health Technology Assessment and Bioinformatics, ONCOTYROL - Center for Personalized Cancer Medicine, Karl-Kapferer-Straße 5, 6020 Innsbruck, Austria. 7. Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnöfer-Zentrum 1, 6060 Hall i.T., Austria. 8. Institute for Health Care Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127 Essen, Germany. 9. Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Ernst von Bergmann Kaserne, Neuherbergstr. 11, 80937 Munich, Germany.
Abstract
BACKGROUND: During the last years, molecular genetic data are increasingly used as prognostic and predictive factors in acute myeloid leukemia (AML). The molecular genetic profile permits a rapid risk categorization and beyond that a prediction of differential treatment efficacy of post-remission chemotherapy versus an allogeneic hematopoietic cell transplantation (HCT) in specific subgroups. METHODS: The aim of this study was to evaluate cost-effectiveness of two different strategies of risk categorization (conventional cytogenetic diagnostics (CCD) versus molecular genetic diagnostics (MGD)) in patients with AML, using a decision-analytic state-transition model. The model is run as (Monte Carlo) microsimulation in which individuals pass through in cycles with a cycle length of one month and a time horizon of ten years. FINDINGS: Results show that on average, individuals within the MGD group generated about US$ 32,000 higher costs but survived about seven months longer than individuals within the CCD group. This leads to an Incremental Cost-Effectiveness Ratio (ICER) of about US$ 4928 per survived month. INTERPRETATION: With a GDP (Gross Domestic Product) of US$ 26,467 (€ 33,630) per capita in Germany in 2012, the base-case ICER of US$ 4928 per survived month projected to US$ 59,136 per survived year is in between the simple GDP and the three times GDP per capita.
BACKGROUND: During the last years, molecular genetic data are increasingly used as prognostic and predictive factors in acute myeloid leukemia (AML). The molecular genetic profile permits a rapid risk categorization and beyond that a prediction of differential treatment efficacy of post-remission chemotherapy versus an allogeneic hematopoietic cell transplantation (HCT) in specific subgroups. METHODS: The aim of this study was to evaluate cost-effectiveness of two different strategies of risk categorization (conventional cytogenetic diagnostics (CCD) versus molecular genetic diagnostics (MGD)) in patients with AML, using a decision-analytic state-transition model. The model is run as (Monte Carlo) microsimulation in which individuals pass through in cycles with a cycle length of one month and a time horizon of ten years. FINDINGS: Results show that on average, individuals within the MGD group generated about US$ 32,000 higher costs but survived about seven months longer than individuals within the CCD group. This leads to an Incremental Cost-Effectiveness Ratio (ICER) of about US$ 4928 per survived month. INTERPRETATION: With a GDP (Gross Domestic Product) of US$ 26,467 (€ 33,630) per capita in Germany in 2012, the base-case ICER of US$ 4928 per survived month projected to US$ 59,136 per survived year is in between the simple GDP and the three times GDP per capita.
Authors: Pablo Gargallo; Merche Molero; Cristina Bilbao; Ruth Stuckey; Estrella Carrillo-Cruz; Lourdes Hermosín; Olga Pérez-López; Antonio Jiménez-Velasco; Elena Soria; Marián Lázaro; Paula Carbonell; Yania Yáñez; Iria Gómez; Marta Izquierdo-García; Jennifer Valero-García; Carlos Ruiz; Esperanza Such; Inés Calabria Journal: Cancers (Basel) Date: 2022-04-14 Impact factor: 6.575