Resumen
Recent evidence has shown that immediate treatment with rituximab induction, with and without maintenance, substantially reduces the need for further treatment in patients with advanced asymptomatic follicular lymphoma. This analysis estimates the cost-effectiveness of immediate treatment approaches in comparison to a watch and wait approach from the perspective of the UK National Health Service. A Markov decision model was developed to estimate the cost-effectiveness of treatment strategies in patients with asymptomatic follicular lymphoma. The model was populated using effectiveness data from a systematic literature review with the key clinical data sourced from a randomised trial, in which the treatment strategies were compared. Costs were estimated using UK national sources. In comparison to watchful waiting, both rituximab strategies were found to be more effective and cost saving. In comparison to rituximab induction, the addition of rituximab maintenance marginally increased effectiveness but substantially increased costs, resulting in an incremental cost-effectiveness ratio (ICER) of £69 406 per quality-adjusted life year (QALY). In probabilistic sensitivity analysis, rituximab induction was found to have a 68% probability of being cost-effective at a threshold of £20 000 per QALY. In conclusion, active treatment with rituximab induction is a cost-effective strategy to adopt in patients with asymptomatic follicular lymphoma.
| Idioma original | English |
|---|---|
| Páginas (desde-hasta) | 52-59 |
| Número de páginas | 8 |
| Publicación | British Journal of Haematology |
| Volumen | 180 |
| N.º | 1 |
| DOI | |
| Estado | Published - ene. 2018 |
Nota bibliográfica
Funding Information:This analysis was developed for a clinical guideline on Non-Hodgkin's lymphoma, commissioned and funded by the National Institute for Health and Care Excellence (NICE) in the UK. All authors contributed to the concept and objectives of the analysis. M Prettyjohns designed and developed the economic model and ran the analyses. The economic implications of the results were interpreted by M Prettyjohns while the implications for clinical practice were interpreted by P Hoskin, C McNamara and D Linch. The draft manuscript was prepared by M Prettyjohns and P Hoskin and was reviewed, edited and revised by all authors.
Publisher Copyright:
© 2017 John Wiley & Sons Ltd.
ASJC Scopus Subject Areas
- Hematology
PubMed: MeSH publication types
- Journal Article
- Research Support, Non-U.S. Gov't
ODS de las Naciones Unidas
Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible
