Cost-effectiveness of zoledronic acid vs clodronic acid for newly-diagnosed multiple myeloma from the United Kingdom healthcare system perspective
A partir des données de l'étude "Medical Research Council Myeloma IX Study", cette étude britannique menée auprès de 1 970 participants compare le rapport coût-efficacité de l'acide zolédronique et de l'acide clodronique pour des patients nouvellement diagnostiqués avec un myélome multiple
Objective: In the Medical Research Council Myeloma IX Study (MMIX), zoledronic acid (ZOL) 4 mg 3–4/week reduced the incidence of skeletal-related events (SREs), increased progression free survival (PFS), and prolonged overall survival (OS), compared with clodronic acid (CLO) 1600 mg daily, in 1970 patients with newly-diagnosed multiple myeloma (MM). Methods: An economic model was used to project PFS, OS, the incidence of SREs and adverse events and expected lifetime healthcare costs for patients with newly-diagnosed MM who are alternatively assumed to receive ZOL or CLO. The incremental cost-effectiveness ratio [ICER] of ZOL vs CLO was calculated as the ratio of the difference in cost to the difference in quality-adjusted life years (QALYs). Model inputs were based on results of MMIX and published sources. Results: Compared with CLO, treatment with ZOL increases QALYs by 0.30 at an additional cost of £1653, yielding an ICER of £5443 per QALY gained. If the threshold ICER is £20,000 per QALY, the estimated probability that ZOL is cost-effective is 90%. Limitations: The main limitation of this study is the lack of data on the effects of zoledronic acid on survival beyond the end of follow-up in the MMIX trial. However, cost-effectiveness was favourable even under the highly conservative scenario in which the timeframe of the model was limited to 5 years. Conclusions: Compared with clodronic acid, zoledronic acid represents a cost-effective treatment alternative in patients with multiple myeloma. Read More: http://informahealthcare.com/doi/abs/10.3111/13696998.2011.653511
http://informahealthcare.com/doi/abs/10.3111/13696998.2011.653511