title: Cost-utility analysis of melphalan plus prednisone with or without interferon-alpha 2b in newly diagnosed multiple myeloma. Results from a randomised controlled trial.
abstract: This study evaluated the cost utility of adding interferon-alpha 2b to conventional treatment in patients with multiple myeloma. It also provides a methodology for transforming complex quality-of-life profiles into a single index value on the conventional 0 to 1 quality-adjusted life-year scale (QALY). From 1990 to 1992, 583 patients with newly diagnosed, symptomatic multiple myeloma were enrolled in a randomised, multicentre, phase III study to evaluate the addition of interferon-alpha 2b to treatment with melphalan and prednisone. Addition of interferon-alpha 2b yielded a 12% increase in median survival time, at the expense of a slight reduction in quality of life during the first year of treatment. The gain in survival time was not large enough to reach statistical significance. Patients receiving interferon-alpha 2b also had a 5- to 6-month prolongation of the plateau phase. Cost per QALY gained by adding interferon-alpha 2b was conservatively estimated at $US110,000. Potentially better cost effectiveness may be found in different treatment regimens or in certain patient subgroups.
authors.affiliation: National Institute of Public Health, Oslo, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Nord
authors.forename: F
authors.initials: F
authors.lastname: Wisløff
authors.forename: M
authors.initials: M
authors.lastname: Hjorth
authors.forename: J
authors.initials: J
authors.lastname: Westin
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis / Q000191:economics*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D008558:Melphalan / Q000191:economics* / Q000627:therapeutic use; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000191:economics*; D011241:Prednisone / Q000191:economics* / Q000627:therapeutic use; D011788:Quality of Life