Economic evaluation of third-line treatment with alemtuzumab for chronic lymphocytic leukaemia.
OBJECTIVE
The objective of this study was to compare the potential economic efficiency of third-line treatment of chronic lymphocytic leukaemia (CLL) with alemtuzumab versus fludarabine, cyclophosphamide and rituximab (FCR).


METHODS
The target population for this study were patients with CLL who were able to tolerate third-line treatment with either FCR or alemtuzumab. The perspective used was that of the New Zealand Pharmaceutical Management Agency (PHARMAC)/District Health Board. Health outcomes considered were survival time from commencement of treatment and quality-adjusted life-years (QALYs) gained. Average costs and outcomes and incremental cost per patient treated, per survival month and per QALY gained, were calculated. All costs were presented in 2006 New Zealand dollars.


RESULTS
Base-case direct medical costs for alemtuzumab per treatment regimen per patient were $NZ15 303 lower than those for FCR. The average direct medical cost per survival month gained for alemtuzumab was $NZ3144 and for FCR was $NZ4101, and the average direct medical cost per QALY gained was $NZ46,016 and for FCR was $NZ60,012.


CONCLUSIONS
Third-line treatment of eligible patients with alemtuzumab was found to be $NZ15,303 less costly than FCR per patient.
Scott
W Guy
WG
ScottEconomics, Wellington, New Zealand. ScottEconomics@xtra.co.nz
Scott
Helen M
HM
D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000191:economics / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000191:economics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017048:Health Care Costs; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D019057:Quality-Adjusted Life Years
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000970:Antineoplastic Agents; D000074323:Alemtuzumab