TY - JOUR
T1 - Cost-effectiveness of the sequential application of tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia
AU - Rochau, Ursula
AU - Sroczynski, Gaby
AU - Wolf, Dominik
AU - Schmidt, Stefan
AU - Jahn, Beate
AU - Kluibenschaedl, Martina
AU - Conrads-Frank, Annette
AU - Stenehjem, David
AU - Brixner, Diana
AU - Radich, Jerald
AU - Gastl, Günther
AU - Siebert, Uwe
N1 - Publisher Copyright:
© 2015 © 2015 Informa UK, Ltd.
PY - 2015/8/3
Y1 - 2015/8/3
N2 - Several tyrosine kinase inhibitors (TKIs) are approved for chronic myeloid leukemia (CML) therapy. We evaluated the long-term cost-effectiveness of seven sequential therapy regimens for CML in Austria. A cost-effectiveness analysis was performed using a state-transition Markov model. As model parameters, we used published trial data, clinical, epidemiological and economic data from the Austrian CML registry and national databases. We performed a cohort simulation over a life-long time-horizon from a societal perspective. Nilotinib without second-line TKI yielded an incremental cost-utility ratio of 121 400 /quality-adjusted life year (QALY) compared to imatinib without second-line TKI after imatinib failure. Imatinib followed by nilotinib after failure resulted in 131 100 /QALY compared to nilotinib without second-line TKI. Nilotinib followed by dasatinib yielded 152 400 /QALY compared to imatinib followed by nilotinib after failure. Remaining strategies were dominated. The sequential application of TKIs is standard-of-care, and thus, our analysis points toward imatinib followed by nilotinib as the most cost-effective strategy.
AB - Several tyrosine kinase inhibitors (TKIs) are approved for chronic myeloid leukemia (CML) therapy. We evaluated the long-term cost-effectiveness of seven sequential therapy regimens for CML in Austria. A cost-effectiveness analysis was performed using a state-transition Markov model. As model parameters, we used published trial data, clinical, epidemiological and economic data from the Austrian CML registry and national databases. We performed a cohort simulation over a life-long time-horizon from a societal perspective. Nilotinib without second-line TKI yielded an incremental cost-utility ratio of 121 400 /quality-adjusted life year (QALY) compared to imatinib without second-line TKI after imatinib failure. Imatinib followed by nilotinib after failure resulted in 131 100 /QALY compared to nilotinib without second-line TKI. Nilotinib followed by dasatinib yielded 152 400 /QALY compared to imatinib followed by nilotinib after failure. Remaining strategies were dominated. The sequential application of TKIs is standard-of-care, and thus, our analysis points toward imatinib followed by nilotinib as the most cost-effective strategy.
KW - Chronic myeloid leukemia
KW - cost-eff ectiveness analysis
KW - decision analysis
KW - decision-analytic model
KW - health economic modeling
KW - tyrosine kinase inhibitors
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U2 - 10.3109/10428194.2014.982635
DO - 10.3109/10428194.2014.982635
M3 - Article
C2 - 25393806
AN - SCOPUS:84943395388
SN - 1042-8194
VL - 56
SP - 2315
EP - 2325
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 8
ER -