Cost-Effectiveness of Zoledronic Acid Compared with Clodronate in Multiple Myeloma

Abstract

phd § cost-effective is 80%. Assuming that the benefits of zoledronic acid on pfs and os diminish over 5 years beginning at the end of year 5, the icer is CAN$63,027 per qaly gained. If the benefits of zoledronic acid on pfs and os are assumed to persist for 5 years only, the icer is CAN$76,948 per qaly gained. ConclusionsCompared with clodronate, zoledronic acid represents a cost-effective treatment alternative in patients with multiple myeloma.

Impact of Country-Specific EQ-5D-3L Tariffs on the Economic Value of Systemic Therapies Used in the Treatment of Metastatic Pancreatic Cancer

“…Many Canadian cost-effectiveness analyses in cancer have been conducted using the utility scores derived from the U.K. tariffs [28][29][30][31] and, to a lesser extent, the U.S. tariffs 32 obtained from the EQ-5D-3L. The implications of this practice of using non-Canadian tariffs have not been determined, and the Canadian Agency for Drugs and Technologies in Health has not yet made an official recommendation on this topic.…”

Decision-analytic modeling studies: An overview for clinicians using multiple myeloma as an example

“…Brown [25] Len-Dex vs. Dex 2nd line therapy of MM Delea [20] ZOL vs. CLO 1st line therapy of MM Delea [19] ZOL vs. CLO 1st line therapy of MM Garrison [23] MPB vs. MPT vs. MPL vs. MPL-L 1st line therapy of MM transplant-ineligible Grima [22] HCO-HD vs. standard HD MM associated renal failure Hornberger [18] B vs. Dex vs. Len-Dex RRMM Kouroukis [16] ASCT vs. MP 1st line therapy of MM transplant-eligible Mehta [28] B vs. BSC vs. T RRMM Moeller [26] Len-Dex vs. B RRMM Picot [21] B and T based combination therapies with alkylators and steroids 1st line therapy of MM more advanced modeling approaches. Statistical fitting methods allow the extrapolation of the survival results beyond the observed time frame, but rely on assumptions that may differ substantially between different parametric models.…”

“…Delea and co-authors [19,20] adapted the same model to reflect Canada and the U.K. in order to evaluate the cost-effectiveness of zoledronic acid (ZA) vs. clodronate. Both analyses concluded that using ZA was the most attractive strategy (US$43,065 per QALY gained in Canada.…”

“…In certain cases, the tail of the extrapolated progression-free survival curve may cross the tail of the overall-survival curve, leading to invalid models and nonsensical survival rates. Four studies [18][19][20][21] applied a SPM. For example, Hornberger et al [18] justified their choice due to the lack of data required to calculate Markov model transition probabilities [18].…”

“…The utility values were primarily elicited within the relevant trials using the EQ-5D [8,[18][19][20]22,23,25,26]. Another study [21] applied utilities elicited using the EORTC QLQ-C30 questionnaire and mapped these values to the EQ-5D.…”