[Drug treatment of chronic myeloid leukemia: a cost effectiveness analysis of first- and second-line treatment ].
OBJECTIVE
To determine the average cost-effectiveness ratio of treatment of patients with chronic myeloid leukaemia (CML): with first-line interferon alpha-2a (IFN) or with second-line imatinib following IFN failure.


METHODS
Cost-effectiveness analysis.


METHODS
A general cost-effectiveness analysis was performed using a model. This model consists of two phases: an induction phase of eight months, in which newly-diagnosed patients are treated with either IFN or imatinib, and a chronic treatment phase wherein patients are treated according the result of the induction phase. The model calculated the costs and effects of the treatment. Input for this model was derived from literature and expert opinion. Costs were based on real cost prices and tariffs.


RESULTS
Treatment with imatinib resulted in 6.67 quality-adjusted life years (QALYs) and treatment with IFN resulted in 4.98 QALYs. Average costs of treatment with 5 million IU/day of IFN were [symbol: see text] 76,969 and [symbol: see text] 53,257 with 3 million IU/day. For imatinib at 400 mg/day the costs were [symbol: see text] 140,765 per patient. Costs per QALY were [symbol: see text] 15,445, [symbol: see text] 10,687 and [symbol: see text] 21,082, respectively.


CONCLUSIONS
The addition of imatinib to the treatment options in CML resulted in increased quality-adjusted survival, but also higher costs of treatment.
Groot
M T
MT
Erasmus Universiteit, Institute for Medical Technology Assessment, Postbus 1738, 3000 DR Rotterdam. groot@bmg.eur.nl
Ossenkoppele
G J
GJ
Kramer
M H
MH
van den Boom
G
G
Huijgens
P C
PC
Uyl-de Groot
C A
CA
D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use*; D001549:Benzamides; D003362:Cost-Benefit Analysis; D006801:Humans; D000068877:Imatinib Mesylate; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000191:economics / Q000627:therapeutic use*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000191:economics; D010879:Piperazines / Q000191:economics / Q000627:therapeutic use*; D011743:Pyrimidines / Q000191:economics / Q000627:therapeutic use*; D011788:Quality of Life; D011994:Recombinant Proteins; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001549:Benzamides; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D010879:Piperazines; D011743:Pyrimidines; D011994:Recombinant Proteins; D000068877:Imatinib Mesylate