The cost-effectiveness of idarubicin/cytosine arabinoside versus daunorubicin/cytosine arabinoside in the treatment of adults with acute myeloid leukemia.
The cost-effectiveness of two chemotherapeutic regimens was evaluated from the results of a randomized clinical trial involving patients with previously untreated acute myeloid leukemia. The evaluable subjects were 120 patients with acute myeloid leukemia randomly assigned to receive 12 mg/m2 of idarubicin (IDA) or 50 mg/m2 of daunorubicin (DNR) daily for three days. The patients also received 200 mg/m2 of cytosine arabinoside daily for five days, with an additional 25-mg/m2 bolus on the first day of treatment, the patients underwent a second course at the same doses. The total hospital charges per patient were $59,687 for IDA treatment and $59,567 for DNR treatment; however, the cost per complete remission was lower in the IDA than in the DNR patients ($74,609 vs $102,115). The lower remission rate in the DNR-treated patients, and thus their need for additional care, will increase the cost differences between the two treatments. The hospital charges per year of survival were $36,395 for IDA treatment and $52,714 for DNR treatment. It is concluded that IDA is more cost-effective than DNR in the treatment of adult acute myeloid leukemia.
Pashko
S
S
Center for Economic Studies in Medicine, Reston, Virginia.
Jacobs
J
J
Santorsa
J
J
D000208:Acute Disease; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000191:economics*; D008297:Male; D012074:Remission Induction
D003561:Cytarabine; D015255:Idarubicin; D003630:Daunorubicin