Economic Evaluation of Third-Line Treatment with Alemtuzumab for Chronic Lymphocytic Leukaemia
The objective of this study was to compare the potential economic efficiency of third-line treatment of chronic lymphocytic leukaemia (CLL) with alemtuzumab versus fludarabine, cyclophosphamide and rituximab (FCR).
The target population for this study were patients with CLL who were able to tolerate third-line treatment with either FCR or alemtuzumab. The perspective used was that of the New Zealand Pharmaceutical Management Agency (PHARMAC)/District Health Board. Health outcomes considered were survival time from commencement of treatment and quality-adjusted life-years (QALYs) gained. Average costs and outcomes and incremental cost per patient treated, per survival month and per QALY gained, were calculated. All costs were presented in 2006 New Zealand dollars.
Base-case direct medical costs for alemtuzumab per treatment regimen per patient were $NZ15 303 lower than those for FCR. The average direct medical cost per survival month gained for alemtuzumab was $NZ3144 and for FCR was $NZ4101, and the average direct medical cost per QALY gained was $NZ46 016 and for FCR was $NZ60 012.
Third-line treatment of eligible patients with alemtuzumab was found to be $NZ15 303 less costly than FCR per patient.
KeywordsChronic Lymphocytic Leukaemia Fludarabine Alemtuzumab Direct Medical Cost Chronic Lymphocytic Leukaemia Patient
A research grant from Bayer Schering Pharma, a division of Bayer New Zealand Limited, made this study possible but had no influence on the structure or content of the study research. Both authors were involved in all stages of the research and publishing process. At the time of the study the authors had no conflicts of interest that were directly relevant to the content of this study. One of the authors is now assisting with a PHARMAC application but was not doing so at the time of the study or writing of the paper.
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