title: Economic evaluation of treatment for acute lymphoblastic leukaemia in childhood.
abstract: Berlin-Frankfurt-Munster (BFM) and Dana-Farber Cancer Institute (DFCI) consortia's treatment strategies for acute lymphoblastic leukaemia (ALL) in children are widely used. We compared the health effects and monetary costs of hospital treatments for these two strategies. Parents of children treated at seven centres in Canada, Italy and the USA completed health-related quality of life (HRQL) assessments during four active treatment phases and at 2 years after treatment. Mean HRQL scores were used to calculate quality-adjusted life years (QALYs) for a period of 5 years following diagnosis. Total costs of treatment were determined from variables in administrative databases in a universally accessible and publicly funded healthcare system. Valid HRQL assessments (n = 1200) were collected for 307 BFM and 317 DFCI patients, with costs measured for 66 BFM and 28 DFCI patients. QALYs per patient were <1.0% greater for BFM than DFCI. Median HRQL scores revealed no difference in QALYs. The difference in mean total costs for BFM (US$88 480) and DFCI (US$93 026) was not significant (P = 0.600). This study provides no evidence of superiority for one treatment strategy over the other. Current BFM or DFCI strategies should represent conventional management for the next economic evaluation of treatments for ALL in childhood.
authors.affiliation: Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Rae
authors.forename: W
authors.initials: W
authors.lastname: Furlong
authors.forename: M
authors.initials: M
authors.lastname: Jankovic
authors.forename: Albert
authors.initials: A
authors.lastname: Moghrabi
authors.forename: A
authors.initials: A
authors.lastname: Naqvi
authors.forename: A
authors.initials: A
authors.lastname: Sala
authors.forename: Y
authors.initials: Y
authors.lastname: Samson
authors.forename: S
authors.initials: S
authors.lastname: DePauw
authors.forename: D
authors.initials: D
authors.lastname: Feeny
authors.forename: R
authors.initials: R
authors.lastname: Barr
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000592:standards / Q000627:therapeutic use*; D002170:Canada; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007558:Italy; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000191:economics / Q000628:therapy*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D014481:United States
keywords: economic evaluation; leukaemia; treatment