Economic analysis of adjuvant therapy with interferon alpha-2a in stage II malignant melanoma.
Using the trial demonstrating that interferonalpha-2a (IFNalpha-2a) is efficacious as adjuvant therapy in stage II melanoma, we evaluate its outcomes and economic consequences. Using rates observed in the 5-year trial and published figures, survival and Q-TWIST (Time Without Symptoms and Toxicity) were extrapolated to a 10-year and lifetime horizon. Cost analysis was performed using the trial's data, published literature and experts' opinions from the perspective of the French Sickness Funds. Patients in the IFNalpha-2a-group have an additional 0.26 years in life-expectancy over a 5-year time period (P=0.046), 0.67 years over a 10-year period and 2.59 years over a lifetime. Cost per life-year-gained was estimated at approximately 14400 after 5 years, 6635 after 10 years and 1716 over a lifetime. Assuming that there is an improvement in disease-free survival only, cost is 26147 per Q-TWIST. Cost-effectiveness of IFNalpha-2a in stage II melanoma compares favourably with estimates for widely used therapies in the oncological field.
Cemka, 43 boulevard du Maréchal Joffre, F-92340, Bourg-la-Reine, France. antoine.lafuma@cemka.fr
A
A
Lafuma
B
B
Dreno
M
M
Delaunay
C
C
Emery
F
F
Fagnani
K
K
Hieke
J J
JJ
Bonerandi
J J
JJ
Grob
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D004180:Direct Service Costs; D016527:Drug Costs; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000191:economics* / Q000627:therapeutic use; D008545:Melanoma / Q000188:drug therapy / Q000191:economics* / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000191:economics; D009367:Neoplasm Staging; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000473:pathology; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins