Comparative cost-effectiveness models for the treatment of multiple myeloma.
OBJECTIVE
To compare cost effectiveness models for the first-line treatment of multiple myeloma, and explore the differences between the models' structure, parameters, assumptions and results.


METHODS
Three cost effectiveness models for the treatment of multiple myeloma, were compared that had been developed to inform resource allocation in the UK for the chemotherapy regimens bortezomib, melphalan and prednisolone (BMP); and melphalan, prednisolone and thalidomide (MPT) versus melphalan and prednisolone (MP). The models used alternative approaches and assumptions to estimate the overall survival and progression-free survival for each of the interventions. Through the use of sensitivity analyses, the most influential parameters and assumptions of each of the models were identified.


RESULTS
The models developed by the manufacturers gave conflicting results, with each manufacturer favouring their drug. The differences between the model results were determined by two parameters: the hazard ratio for overall survival for MPT vs. MP and the cost of bortezomib.


CONCLUSIONS
Using models developed for assessing treatments for multiple myeloma we demonstrated that it was feasible to compare models, which then aided decision makers in making reimbursement decisions.
Southampton Health Technology Assessments Centre (SHTAC), University of Southampton.
Keith
K
Cooper
Southampton Health Technology Assessments Centre (SHTAC), University of Southampton.
Joanna
J
Picot
Southampton Health Technology Assessments Centre (SHTAC), University of Southampton.
Jackie
J
Bryant
Southampton Health Technology Assessments Centre (SHTAC), University of Southampton.
Andrew
A
Clegg
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics* / Q000627:therapeutic use; D001897:Boronic Acids / Q000008:administration & dosage / Q000191:economics; D000069286:Bortezomib; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D006801:Humans; D008558:Melphalan / Q000008:administration & dosage / Q000191:economics; D018803:Models, Economic; D009101:Multiple Myeloma / Q000178:diet therapy*; D011239:Prednisolone / Q000008:administration & dosage / Q000191:economics; D011719:Pyrazines / Q000008:administration & dosage / Q000191:economics; D016019:Survival Analysis; D013792:Thalidomide / Q000008:administration & dosage / Q000191:economics; D006113:United Kingdom
D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D011239:Prednisolone; D008558:Melphalan