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Research article
Frederick Thielen
Erasmus School of Health Policy and Management
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0312-5891
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Efficacy of lenalidomide plus rituximab (R-LEN) compared to rituximab monotherapy (R-mono) for patients with previously treated follicular lymphoma (FL) was investigated in AUGMENT (NCT01938001). Our aim was to evaluate the cost-effectiveness of R-LEN versus R-mono in this setting from a Dutch perspective.
Methods: Cost-effectiveness was assessed through a partitioned survival model with three health states from three perspectives (i.e. societal, healthcare and societal including future non-medical costs). Patient-level data from AUGMENT informed effectiveness parameters (i.e. long-term survival) and health state utilities. Resource use and prices were based on AUGMENT and the literature. Clinical experts validated efficacy input parameters and results. Uncertainty was explored through sensitivity and scenario analyses.
Results: R-LEN resulted in 1.7 incremental discounted QALYs. Total incremental discounted costs were 67,161 EUR from a societal perspective, resulting in an incremental cost-effectiveness ratio (ICER) of 40,493 EUR/QALY (healthcare: 37,951 EUR/QALY; societal including future non-medical costs: 49,296 EUR/QALY). Sensitivity analyses indicated some uncertainty in the model results. In some scenarios R-LEN exceed an ICER of 50,000 EUR/QALY.
Conclusion: R-LEN was cost-effective at a willingness-to-pay (WTP) threshold of 50,000 EUR/QALY in the base-case analyses. Scenario and sensitivity analyses indicated some level of uncertainty regarding this conclusion, depending on the chosen WTP-threshold and perspective.
Keywords
rituximab, EUR/QALY, willingness-to-pay (WTP)
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
Frederick Thielen
Erasmus School of Health Policy and Management
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0312-5891
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 01 Dec, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Efficacy of lenalidomide plus rituximab (R-LEN) compared to rituximab monotherapy (R-mono) for patients with previously treated follicular lymphoma (FL) was investigated in AUGMENT (NCT01938001). Our aim was to evaluate the cost-effectiveness of R-LEN versus R-mono in this setting from a Dutch perspective.
Methods: Cost-effectiveness was assessed through a partitioned survival model with three health states from three perspectives (i.e. societal, healthcare and societal including future non-medical costs). Patient-level data from AUGMENT informed effectiveness parameters (i.e. long-term survival) and health state utilities. Resource use and prices were based on AUGMENT and the literature. Clinical experts validated efficacy input parameters and results. Uncertainty was explored through sensitivity and scenario analyses.
Results: R-LEN resulted in 1.7 incremental discounted QALYs. Total incremental discounted costs were 67,161 EUR from a societal perspective, resulting in an incremental cost-effectiveness ratio (ICER) of 40,493 EUR/QALY (healthcare: 37,951 EUR/QALY; societal including future non-medical costs: 49,296 EUR/QALY). Sensitivity analyses indicated some uncertainty in the model results. In some scenarios R-LEN exceed an ICER of 50,000 EUR/QALY.
Conclusion: R-LEN was cost-effective at a willingness-to-pay (WTP) threshold of 50,000 EUR/QALY in the base-case analyses. Scenario and sensitivity analyses indicated some level of uncertainty regarding this conclusion, depending on the chosen WTP-threshold and perspective.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
This is a list of supplementary files associated with this preprint. Click to download.
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