Bortezomib-Based Regimens Used As Induction In Newly Diagnosed Multiple Myeloma (Ndmm) Patients Eligible For Stem Cell Transplantation (Sct)The Cost-Utility Analysis

Abstract

A229Objectives: In Mexico, iron deficiency anemia (IDA) is frequent and varies according to age: children between 0 and 5 years: 23.7%, women between 15 and 44.99 years: 15.6%, pregnant women 20.6%. Intravenous iron (IV) is a treatment option for IDA when patients are intolerant to oral iron or there is a need to replenish iron stores. The objective of this study was to estimate the relative direct health care costs of ferric carboxymaltose (FCM), IV iron dextran (ID), and red-blood cells (RBC) transfusions for patients with IDA in Mexican private hospitals. The assessment has been made from the third party payer perspective represented by health insurances across multiple therapeutic areas (TA) (gastroenterology, gynecology, and surgery). MethOds: A cost-minimization analysis assuming similar efficacy and safety of the alternatives was conducted since the evidence of IV ID is limited in the selected TAs limiting our ability for indirect comparisons. Mean IV iron dose needed to correct IDA is estimated to be 1000 mg per patient and IV infusion time required is based on the Mexican SmPc for both products (FCM 15 minutes versus ID 6 hours). Mean cost of infusions was calculated based on daily hospitalization costs according to national tariffs (according to 5 private health care institutions). Cost savings due to IV iron-induced reduction of RBC transfusion before hip and knee surgery are based on published evidence (Kotze et al). Results: In all the TAs, the use of FCM compared to ID regarding infusion efficiency derived from reduced hospitalization time and IV iron-induced reduction of RBC transfusions resulted in substantial cost savings. Independently of the TA, mean costs savings per patient were $6980 Mexican pesos. cOnclusiOns: This study showed that the utilization of FCM could reduce costs to the health insurances at private hospitals due to improved administration efficiency and reduction in RBC transfusions. PSY34CoSt-MiniMization analYSiS of anti-tnf BiologiCS in the treatMent of rheuMatoid arthritiS,

Cost-effectiveness of bortezomib for multiple myeloma: a systematic review

“…Two CEAs compared BTZ/thalidomide/DEX (VTD) versus CTD and thalidomide/DEX (TD) in Poland and Germany, respectively. 13 , 14 The base case ICERs per gained QALY for VTD versus CTD and TD were 0.5588 and 0.9864 GDPPC, respectively in Poland. However, the base case ICER per gained QALY for VTD versus TD in Germany (0.9299 GDPPC) was only half that of the ICER in Poland.…”

“…Of these eleven abstracts, only two abstracts were qualified for inclusion. Thus, this systematic review included 17 CEAs, including 3 CEAs (Kouroukis et al, 12 Mucha et al, 13 and Van Beurden-Tan et al 14 ) assessing BTZ-containing regimens as induction treatment prior to SCT, 6 CEAs (Rickert et al, 15 Garrison et al, 16 Oster et al, 17 Picot et al, 18 Yoong et al, 19 and Cavenagh et al 20 ) assessing VMP for previously untreated and SCT-ineligible MM, and 8 CEAs (Bagust et al, 21 Mehta et al, 22 Felix et al, 23 Fragoulakis et al, 24 Hornberger et al, 25 Jiang et al, 26 Liwing et al, 27 and Moller et al 28 ) assessing BTZ for relapsed/refractory MM. The literature search process is illustrated in Figure 1 , and the excluded references from the final assessment of study eligibility are summarized in Table S1 .…”

“…The base case ICER per gained QALY for BTZ-containing regimens versus non-BTZ treatments in the Canadian CEA based on IFM 2005-01 phase III trial 29 was 2.2544 GDPPC. The Polish CEA 13 compared bortezomib/dexamethasone (VD) versus vincristine/adriamycin/dexamethasone (VAD) and cyclophosphamide/thalidomide/DEX (CTD) likely using an indirect comparison method to estimate treatment efficacies associated with the two treatments from two trials. 29 , 30 The reported base case ICERs per gained QALY for VD versus VAD and CTD were 1.0083 and 1.2584 GDPPC, respectively.…”