title: Economic evaluation of rituximab plus cyclophosphamide, vincristine and prednisolone for advanced follicular lymphoma.
abstract: The addition of rituximab to cyclophosphamide, vincristine and prednisolone (CVP) for advanced follicular lymphoma increases median time to progression by 17 months. A US societal cost-effectiveness of R-CVP versus CVP is estimated for a representative 50-year-old patient. Progression-free survival (PFS) and overall survival are based on a randomized Phase III trial. Costs are estimated using Medicare reimbursement rates and published drug price data, and include drug and administration costs, adverse events, treatment of relapses, and end-of-life care. Utility estimates are derived from the literature and a 3% discount rate is employed. Mean overall survival is projected to be 1.51 years longer for patients assigned to R-CVP versus CVP. The cost per quality-adjusted year of life gained is $28,565. The utility associated with stable or progressive disease and the unit drug cost of rituximab most influence the findings. The cost-effectiveness ratio of R-CVP compared with CVP is projected to be cost-effective in the United States under a range of sensitivity analyses.
authors.affiliation: Cedar Associates LLC, Menlo Park, CA, USA. jhornberger@cedarecon.com
authors.forename: John
authors.initials: J
authors.lastname: Hornberger
authors.forename: Carolina
authors.initials: C
authors.lastname: Reyes
authors.forename: Deborah
authors.initials: D
authors.lastname: Lubeck
authors.forename: Nancy
authors.initials: N
authors.lastname: Valente
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000191:economics*; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003520:Cyclophosphamide / Q000008:administration & dosage; D016527:Drug Costs; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy*; D008875:Middle Aged; D018803:Models, Economic; D011239:Prednisolone / Q000008:administration & dosage; D000069283:Rituximab; D016879:Salvage Therapy / Q000191:economics / Q000379:methods; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D003520:Cyclophosphamide; D011239:Prednisolone