2011
DOI: 10.3111/13696998.2011.631067 View full text |Buy / Rent full text
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Abstract: Results demonstrate that azacitidine provides greater clinical benefit and costs less than decitabine across all key outcomes. These results accentuate the positive role of azacitidine in providing cost-effective care for MDS.

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“…A recent study compared azacitidine with decitabine and found that azacitidine was a cost-effective treatment for MDS according to U.S. National Healthcare Input data [34], with a comparative gain of 0.171 more QALYs and savings of €15,890 over a 2-year period. However, the relevance of the study is limited, mainly because survival data was retrieved from two different phase III trials and no direct comparison was made.…”
Section: Discussionmentioning
“…The results of our analysis demonstrate that the economic value for treatment of higher-risk mds patients with azacitidine is within the range of currently reimbursed oncology medicines in Canada. The study by Gidwani et al 20 evaluated the costeffectiveness of azacitidine compared with decitabine in mds over a 2-year time horizon from a U.S. payer perspective. The study concluded that azacitidine dominated decitabine by providing greater clinical benefit at a lower cost, and the results were robust in most of the sensitivity analyses conducted.…”
Section: Discussionmentioning
“…Hypothetical cohorts of patients were simulated to initiate one of the following treatments: BSC (red blood cell transfusions, platelet transfusions and growth factor support), LIC, HIC, switching HMA and allogeneic HCT. Clinical inputs were based on the published literature [3,16,18] and expert opinion, and costs were estimated from published literature [12, [24][25][26][27][28][29][30][31] and publicly available databases [32]. For each model strategy, we projected the costs (2014 US dollars) and life expectancy in life years (LYs) over a lifetime.…”
Section: Patient Population and Treatmentmentioning
“…Red blood cell and platelet requirements range from 1.3 units per event for patients on BSC to 9.0 units for patients receiving HCT. Costs for platelet and red blood cell transfusions (Table 2) were derived from a cost-effectiveness analysis of first-line HMA therapy in patients with MDS [29]. It was …”
Section: Adverse Event Inputsmentioning
“…Phase III trials comparing AZA or DAC to conventional treatment including best supportive care (BSC) have yielded different results. Indirect comparisons by meta-analyses or medico-economic studies suggesting a benefit of AZA over DAC therefore have to be subject to caution [21][22][23]. In contrast, two phase III trials of DAC, both performed with the potentially sub-optimal 3-day i.v.…”
Section: Choosing a Hypomethylating Agentmentioning