NICE guidance on bortezomib and thalidomide for first-line treatment of multiple myeloma

Doss, Sally; Hay, Nicola; Sutcliffe, Frances

doi:10.1016/s1470-2045(11)70202-9

Cited by 8 publications

(7 citation statements)

References 4 publications

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“…Saret et al evaluated the 29 studies listed in Table . They addressed the cost‐effectiveness of drugs approved between 1986 and 2006 (median year of Food and Drug Administration approval, 2001) in studies published between 1995 and 2012 (median year of publication, 2006).…”

Section: Reanalysis Of Cost‐effectiveness Studiesmentioning

confidence: 99%

“…In our analysis, we updated the ICERs of these studies by using the US drug prices in 2014. We excluded 9 studies for the following reasons: 1) 3 studies compared interferon‐α with hydroxyurea or the addition of cytarabine to interferon for CML (these were not used in CML therapy in 2014; 2) 1 study in 1997 evaluated the addition of interferon for the treatment of myeloma (this was not the standard of care in 2014); 3) 2 studies of lymphoma did not have the data needed to calculate ICERs in 2014; 4) 1 study evaluated alemtuzumab for CLL (alemtuzumab was withdrawn from the market and reintroduced under a different label to treat multiple sclerosis); 5) 1 study evaluated autologous stem cell transplantation for multiple myeloma (not drug therapy); and 6) 1 study was a UK guidance on thalidomide and bortezomib in myeloma that did not provide details for recalculating the ICER in 2014 . We were left with 20 studies and 24 cost‐effectiveness analyses.…”

Section: Reanalysis Of Cost‐effectiveness Studiesmentioning

confidence: 99%

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Are high drug prices for hematologic malignancies justified? A critical analysis

Chhatwal

Mathisen

Kantarjian

2015

Cancer

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In the past 15 years, treatment outcomes for hematologic malignancies have improved substantially. However, drug prices have also increased drastically. This commentary examines the value of the treatment of hematologic malignancies at current prices in the United States through a reanalysis of a systematic review evaluating 29 studies of 9 treatments for 4 hematologic malignancies. Incremental cost‐effectiveness ratios (ICERs) were calculated on the basis of drug prices in the United States in 2014. Sixty‐three percent of the studies (15 of 24) had ICERs higher than $50,000 per quality‐adjusted life‐year (QALY), the benchmark widely used by health economists to define cost‐effectiveness. In studies evaluating the current standard‐of‐care treatments for chronic myeloid leukemia, the ICERs for tyrosine kinase inhibitors versus hydroxyurea or interferon ranged from $210,000 to $426,000/QALY. The lower ICER values were mostly obtained from 11 studies evaluating rituximab, which was approved by the Food and Drug Administration in 1997 (ICER range, $37,000‐$69,000/QALY). In conclusion, the costs of the majority of new treatments for hematologic cancers are too high to be deemed cost‐effective in the United States. Cancer 2015;121:3435–43. © 2015 American Cancer Society.

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Section: Reanalysis Of Cost‐effectiveness Studiesmentioning

confidence: 99%

Section: Reanalysis Of Cost‐effectiveness Studiesmentioning

confidence: 99%

Are high drug prices for hematologic malignancies justified? A critical analysis

Chhatwal

Mathisen

Kantarjian

2015

Cancer

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“…The literature search identified twenty-six unique studies: three guidelines based on systematic reviews [7][8][9] , six systematic reviews 5,[10][11][12][13][14] , seventeen rcts 15-31 and forty-seven related publications . Figure 1 shows the study flow chart, and Table i presents the studies with their related publications and objectives.…”

Section: Literature Searchmentioning

confidence: 99%

Bortezomib in Multiple Myeloma: Systematic Review and Clinical Considerations

Kouroukis

Baldassarre²,

Haynes³

et al. 2014

Current Oncology

102

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We conducted a systematic review to determine the appropriate use of bortezomib alone or in combination with other agents in patients with multiple myeloma (MM). We searched MEDLINE, EMBASE, the Cochrane Library, conference proceedings, and the reference lists of included studies. We analyzed randomized controlled trials and systematic reviews if they involved adult MM patients treated with bortezomib and if they reported on survival, disease control, response, quality of life, or adverse effects. Twenty-six unique studies met the inclusion criteria. For patients with previously untreated MM and for candidates for transplantation, we found a statistically significant benefit in time to progression [hazard ratio (HR): 0.48, p < 0.001; and HR: 0.63, p = 0.006, respectively] and a better response with a bortezomib than with a non-bortezomib regimen (p < 0.001). Progression-free survival was longer with bortezomib and thalidomide than with thalidomide alone (p = 0.01). In non-candidates for transplantation, a significant benefit in overall survival was observed with a bortezomib regimen (HR compared with a non-bortezomib regimen: 0.61; p = 0.008), and in transplantation candidates receiving bortezomib, the response rate was improved after induction (p = 0.004) and after a first transplant (p = 0.016). In relapsed or refractory MM, overall survival (p = 0.03), time to progression (HR: 1.82; p = 0.000004), and progression-free survival (HR: 1.69; p = 0.000026) were significantly improved with bortezomib and pegylated liposomal doxorubicin (compared with bortezomib alone), and bortezomib monotherapy was better than dexamethasone alone (HR: 0.77; p = 0.027). Bortezomib combined with thalidomide and dexamethasone was better than either bortezomib monotherapy or thalidomide with dexamethasone (p < 0.001). In previously untreated or in relapsed or refractory MM patients, bortezomib-based therapy has

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“…8 (A higher threshold would expand the range of analyses considered cost effective, which would mean that our analysis is conservative and that more of the CEAs included should be considered cost effective.) Four ratios, 1 of them industry funded, exceeded $100 000/ QALY, including 2 pertaining to treatment of MM with bortezomib, 9,10 1 pertaining to treatment of CML with interferon-a, 11 and 1 pertaining to treatment of CML with imatinib. In 2 other cases, both industry funded (alemtuzumab to treat chronic lymphocytic leukemia and bortezomib to treat MM), the treatment improved health and reduced costs.…”

Section: Resultsmentioning

confidence: 99%

Value of innovation in hematologic malignancies: a systematic review of published cost-effectiveness analyses

Saret

Winn

Shah

et al. 2015

Blood

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We analyzed cost-effectiveness studies related to hematologic malignancies from the Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegistry.org), focusing on studies of innovative therapies. Studies that met inclusion criteria were categorized by 4 cancer types (chronic myeloid leukemia, chronic lymphocytic leukemia, non-Hodgkin lymphoma, and multiple myeloma) and 9 treatment agents (interferon-α, alemtuzumab, bendamustine, bortezomib, dasatinib, imatinib, lenalidomide, rituximab alone or in combination, and thalidomide). We examined study characteristics and stratified cost-effectiveness ratios by type of cancer, treatment, funder, and year of study publication. Twenty-nine studies published in the years 1996-2012 (including 44 cost-effectiveness ratios) met inclusion criteria, 22 (76%) of which were industry funded. Most ratios fell below $50 000 per quality-adjusted life-years (QALY) (73%) and $100 000/QALY (86%). Industry-funded studies (n = 22) reported a lower median ratio ($26 000/QALY) than others (n = 7; $33 000/QALY), although the difference was not statistically significant. Published data suggest that innovative treatments for hematologic malignancies may provide reasonable value for money.

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NICE guidance on bortezomib and thalidomide for first-line treatment of multiple myeloma

Cited by 8 publications

References 4 publications

Are high drug prices for hematologic malignancies justified? A critical analysis

Are high drug prices for hematologic malignancies justified? A critical analysis

Bortezomib in Multiple Myeloma: Systematic Review and Clinical Considerations

Value of innovation in hematologic malignancies: a systematic review of published cost-effectiveness analyses

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