Cost-Effectiveness Analysis of Bendamustine Plus Rituximab as a First-Line Treatment for Patients with Follicular Lymphoma in Spain

Sabater, E.; López‐Guillermo, Armando; Rueda, Antonio; Salar, Antonio; Oyagüez, Itziar; Collar, J.M.

doi:10.1007/s40258-016-0243-4

Cited by 6 publications

(9 citation statements)

References 27 publications

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“…Six studies were found to report cost effectiveness of treatments for relapsed/refractory (R/R) FL, while only three studies reported cost-effectiveness evidence for refractory FL. A Markov modelling approach, mainly depicting a three-state disease model (progression-free, progressive disease and death), was used in the majority of costeffectiveness publications [8,11,18,[20][21][22][23][24][25]. Other analysis types used included cohort-based analysis [26], probabilistic decision analytic model [9], transitional state model [19], and a partitioned survival model [27].…”

Section: Model/analysis Design Overviewmentioning

confidence: 99%

Cost-Effectiveness Analyses, Costs and Resource Use, and Health-Related Quality of Life in Patients with Follicular or Marginal Zone Lymphoma: Systematic Reviews

Monga¹,

Garside

Gurung

et al. 2020

PharmacoEconomics Open

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Background Follicular lymphoma (FL) and marginal zone lymphoma (MZL) are types of indolent non-Hodgkin lymphoma (NHL) that develop in the B lymphocytes (also known as B cells).Objective The aim of this study was to conduct a comprehensive review of studies relating to cost effectiveness, costs and resource use, and health-related quality of life (HRQoL) in patients with FL or MZL. Methods Three separate systematic reviews were conducted to identify all published evidence on cost effectiveness, costs and resource use, and HRQoL between 2007 and March 2017 using the MEDLINE ® , MEDLINE in-process, E-pubs ahead of print (Ovid SP ® ), Embase (Ovid SP ® ), NHS EED, and EconLit databases. Select congress proceedings were also searched. Two systematic reviewers independently reviewed titles, abstracts, and full papers against eligibility criteria. Relevant data were extracted into bespoke data extraction templates (DETs) by a single systematic reviewer; these data were then validated for accuracy by a second reviewer against clean copies of the relevant publications. Results A total of 25 cost-effectiveness studies (24 in FL; 1 in FL and MZL) met the eligibility criteria. Markov models were the most utilised cost-effectiveness model. US FL studies reported an incremental cost-effectiveness ratio (ICER) of $28,565/QALY for first-line rituximab-cyclophosphamide, vincristine, and prednisone (R-CVP) versus CVP, and $43,000/ QALY for second-line obinutuzumab plus bendamustine (G + B) followed by G maintenance versus B. In the UK, ICERs were £1529-10,834/quality-adjusted life-year (QALY) for first-line rituximab + chemotherapy versus chemotherapy, £27,988/ QALY for second-line G + B + G-maintenance versus B, and £62,653/QALY for second-line idelalisib versus chemotherapy and/or rituximab. Five costs/resource use and four HRQoL studies were identified in FL, and none in MZL. US mean lifetime costs in first-line patients ranged from $108,000 (rituximab) to $130,300 (rituximab-cyclophosphamide, doxorubicin hydrochloride, vincristine and prednisolone [CHOP]), and from £2185 (watch-and-wait) to £17,054 (chemotherapy) in the UK. In a multinational study, more rituximab-refractory patients receiving G + B + G-maintenance reported a meaningful improvement in total FACT-Lym scores compared with patients receiving B. In the UK, total FACT-Lym scores were meaningfully higher for newly diagnosed patients compared with patients with progression (136.04 vs. 109.7). Conclusions and RelevanceWe found a small body of evidence of quality of life, and potentially cost-effective treatment options for FL; however, no evidence was reported on MZL specifically. The significant data gaps in knowledge in these diseases demonstrate a marked need for further studies.

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Section: Model/analysis Design Overviewmentioning

confidence: 99%

Cost-Effectiveness Analyses, Costs and Resource Use, and Health-Related Quality of Life in Patients with Follicular or Marginal Zone Lymphoma: Systematic Reviews

Monga¹,

Garside

Gurung

et al. 2020

PharmacoEconomics Open

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“…Studies recruiting an EU population accounted for the greatest proportion of research (41%) ( Figure 2D). (16 studies [24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39])…”

Section: Study Characteristicsmentioning

confidence: 99%

“…CIA management costs associated with CHOP or some variation have been included in several economic modelling studies but they focus on inpatient costs only, and are largely not contemporary estimates (pre-2014) [26,34,36]. One Dutch study reported other medical resource use associated with CIA limited to moderate costs associated with transfusion (costs of RBCs transfused EUR 398 to EUR 553 (cost year not stated) [44]).…”

Section: Summary Findings: Febrile Neutropeniamentioning

confidence: 99%

“…Costs were attributed to prolonged hospitalization with complicated and costly procedures. Costs of management per sepsis/infection event in the EU were EUR 10,290 (2013 EUR) [36] and GBP 1,077 (cost year not stated [34]).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Four studies provided data for the treatment of thrombocytopenia in relation to CHOP chemotherapy in lymphoma. Platelet transfusions for Grade 3 or 4 thrombocytopenia were infrequently reported [26,36] and overall transfusion rates varied between 2% and 6% [43,44].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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Exploring the burden of short-term CHOP chemotherapy adverse events in post-transplant lymphoproliferative disease: a comprehensive literature review in lymphoma patients

Watson

Barlev

Worrall³

et al. 2020

Journal of Drug Assessment

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Purpose: CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) is a treatment for post-transplant lymphoproliferative disease (PTLD) following solid organ transplant after failing rituximab, an aggressive and potentially fatal lymphoma. This study explores the humanistic and economic burden of CHOP-associated adverse events (AEs) in PTLD patients. Since PTLD is rare, searches included lymphoproliferative disease with lymphoma patients. Design: This comprehensive literature review used the PRISMA protocol, pre-specifying the search strategy and criteria. CHOP-associated short-term AEs with an incidence of >4% were sourced from published literature and cancer websites to inform the search strategy. PubMed and EMBASE searches were used to identify humanistic and economic burden studies. Results: PubMed and EMBASE searches identified 3,946 citations with 27 lymphoma studies included. Studies were methodologically heterogeneous. Febrile neutropenia (FN) was the AE most encountered, followed by chemotherapy-induced (CI) anemia (A), infection, CI-nausea and vomiting, thrombocytopenia, and CI-peripheral neuropathy (PN). FN and infections were associated with significant disutility, increased hospitalization, and extended length of stay. Infections and CIPN significantly impacted the utility of patients and CIA-related fatigue showed reductions in quality of life. Many patients continue to have quality of life deficits continued even after AEs were treated.

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Sensitivity Analysis in Economic Evaluations of Immuno-Oncology Drugs: A Systematic Literature Review

Iliadou¹,

Athanasakis²

2023

Value in Health Regional Issues

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Cost-Effectiveness Analysis of Bendamustine Plus Rituximab as a First-Line Treatment for Patients with Follicular Lymphoma in Spain

Abstract: First-line therapy with rituximab-bendamustine in FL patients was the dominant strategy over treatment with R-CHOP; it showed cost savings and higher health benefits for the Spanish NHS.

Cited by 6 publications

References 27 publications

Cost-Effectiveness Analyses, Costs and Resource Use, and Health-Related Quality of Life in Patients with Follicular or Marginal Zone Lymphoma: Systematic Reviews

Cost-Effectiveness Analyses, Costs and Resource Use, and Health-Related Quality of Life in Patients with Follicular or Marginal Zone Lymphoma: Systematic Reviews

Exploring the burden of short-term CHOP chemotherapy adverse events in post-transplant lymphoproliferative disease: a comprehensive literature review in lymphoma patients

Sensitivity Analysis in Economic Evaluations of Immuno-Oncology Drugs: A Systematic Literature Review

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