Cost-effectiveness Analysis of Rituximab Maintenance Treatment in Patients With Follicular Lymphoma who Respond to First Line Induction Therapy in Portugal

Detalhes bibliográficos
Autor(a) principal: Carvalho, Susana
Data de Publicação: 2016
Outros Autores: Gomes, Marília, Marques, Herlander, Pereira, Catarina, Rubio-Rodríguez, Darío, Rubio-Terrés, Carlos, Sottomayor, Carlos
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.25756/rpf.v8i1.90
Resumo: Introduction: To perform a cost-effectiveness analysis of follicular lymphoma maintenance treatment after first-line induction with rituximab compared to observation in Portugal.Methods: A Markov follicular lymphoma model was developed with four health states: progression free survival on first and second lines, progression and death. The transition probabilities between health states were obtained from the PRIMA and EORTC20981 clinical trials and the health states utilities from the literature. The analysis considered the Portuguese National Health Service perspective and includes only direct costs. Resource consumption was estimated by a Portuguese clinical expert panel. The unit costs (€ in 2014) were estimated using Portuguese official databases. Deterministic and probabilistic analyses were performed.Results: In the base case, for a time horizon of 10 years, the cost per life year gained and per quality-adjusted life-year were € 10,634 and € 10,664, respectively. The sensitivity analyses confirmed the stability of the base case for time horizons of 20 and 30 years, varying between € 7,430 and € 7,155. Maintenance with rituximab is cost-effective for a time horizon of 5.5 years (cost per quality-adjusted life-year gained of € 23,616).Conclusion: According to the present model rituximab maintenance treatment of follicular lymphoma patients that respond to first line induction therapy in comparison with observation is cost-effective in Portugal.
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spelling Cost-effectiveness Analysis of Rituximab Maintenance Treatment in Patients With Follicular Lymphoma who Respond to First Line Induction Therapy in PortugalAnálise de Custo-efetividade de Rituximab no Tratamento de Manutenção de Doentes com Linfoma Folicular, Com Resposta à Terapêutica de Indução em Primeira Linha, em PortugalIntroduction: To perform a cost-effectiveness analysis of follicular lymphoma maintenance treatment after first-line induction with rituximab compared to observation in Portugal.Methods: A Markov follicular lymphoma model was developed with four health states: progression free survival on first and second lines, progression and death. The transition probabilities between health states were obtained from the PRIMA and EORTC20981 clinical trials and the health states utilities from the literature. The analysis considered the Portuguese National Health Service perspective and includes only direct costs. Resource consumption was estimated by a Portuguese clinical expert panel. The unit costs (€ in 2014) were estimated using Portuguese official databases. Deterministic and probabilistic analyses were performed.Results: In the base case, for a time horizon of 10 years, the cost per life year gained and per quality-adjusted life-year were € 10,634 and € 10,664, respectively. The sensitivity analyses confirmed the stability of the base case for time horizons of 20 and 30 years, varying between € 7,430 and € 7,155. Maintenance with rituximab is cost-effective for a time horizon of 5.5 years (cost per quality-adjusted life-year gained of € 23,616).Conclusion: According to the present model rituximab maintenance treatment of follicular lymphoma patients that respond to first line induction therapy in comparison with observation is cost-effective in Portugal.Introdução: Realizar uma análise de custo-efetividade de rituximab no tratamento de manutenção do linfoma folicular após indução em primeira linha, em comparação com observação, em Portugal.Métodos: Desenvolveu-se um modelo de Markov para o linfoma folicular com quatro estados de saúde: sobrevivência livre de progressão, após primeira e segundas linhas, progressão e morte. As probabilidades de transição entre estados de saúde foram obtidas a partir dos ensaios clínicos PRIMA e EORTC20981 e as respetivas utilidades a partir da literatura. A perspetiva da análise foi a do Serviço Nacional de Saúde português e incluiu apenas os custos diretos. O consumo de recursos foi estimado por um painel de peritos constituído por clínicos portugueses. Os custos unitários (€ em 2014) foram estimados usando bases de dados oficiais portuguesas. Realizaram-se análises determinísticas e probabilísticas.Resultados: No cenário base, para um horizonte temporal de dez anos, os custos por ano de vida ganho e por ano de vida ajustado pela qualidade foram de € 10 634 e € 10 664, respetivamente. As análises de sensibilidade confirmaram os resultados do cenário-base para horizontes temporais de 20 e 30 anos, variando entre € 7430 e € 7155. O tratamento de manutenção com rituximab é custo-efetivo para um horizonte temporal de 5,5 anos (custo por ano de vida ajustado pela qualidade ganho de € 23 616).Conclusão: De acordo com o atual modelo, o tratamento de manutenção com rituximab em doentes com linfoma folicular que responderam à terapêutica de indução em primeira linha, em comparação com a observação, é custo-efetivo em Portugal.Formifarma2016-03-12info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.25756/rpf.v8i1.90https://doi.org/10.25756/rpf.v8i1.90Revista Portuguesa de Farmacoterapia / Portuguese Journal of Pharmacotherapy; Vol 8 No 1 (2016): Janeiro; 17-26Revista Portuguesa de Farmacoterapia; v. 8 n. 1 (2016): Janeiro; 17-262183-73411647-354Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://revista.farmacoterapia.pt/index.php/rpf/article/view/90http://revista.farmacoterapia.pt/index.php/rpf/article/view/90/75Direitos de Autor (c) 2017 Revista Portuguesa de Farmacoterapiahttp://creativecommons.org/licenses/by-nc-nd/4.0info:eu-repo/semantics/openAccessCarvalho, SusanaGomes, MaríliaMarques, HerlanderPereira, CatarinaRubio-Rodríguez, DaríoRubio-Terrés, CarlosSottomayor, Carlos2023-09-01T04:33:24Zoai:ojs.farmacoterapia.pt:article/90Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:11:33.547458Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Cost-effectiveness Analysis of Rituximab Maintenance Treatment in Patients With Follicular Lymphoma who Respond to First Line Induction Therapy in Portugal
Análise de Custo-efetividade de Rituximab no Tratamento de Manutenção de Doentes com Linfoma Folicular, Com Resposta à Terapêutica de Indução em Primeira Linha, em Portugal
title Cost-effectiveness Analysis of Rituximab Maintenance Treatment in Patients With Follicular Lymphoma who Respond to First Line Induction Therapy in Portugal
spellingShingle Cost-effectiveness Analysis of Rituximab Maintenance Treatment in Patients With Follicular Lymphoma who Respond to First Line Induction Therapy in Portugal
Carvalho, Susana
title_short Cost-effectiveness Analysis of Rituximab Maintenance Treatment in Patients With Follicular Lymphoma who Respond to First Line Induction Therapy in Portugal
title_full Cost-effectiveness Analysis of Rituximab Maintenance Treatment in Patients With Follicular Lymphoma who Respond to First Line Induction Therapy in Portugal
title_fullStr Cost-effectiveness Analysis of Rituximab Maintenance Treatment in Patients With Follicular Lymphoma who Respond to First Line Induction Therapy in Portugal
title_full_unstemmed Cost-effectiveness Analysis of Rituximab Maintenance Treatment in Patients With Follicular Lymphoma who Respond to First Line Induction Therapy in Portugal
title_sort Cost-effectiveness Analysis of Rituximab Maintenance Treatment in Patients With Follicular Lymphoma who Respond to First Line Induction Therapy in Portugal
author Carvalho, Susana
author_facet Carvalho, Susana
Gomes, Marília
Marques, Herlander
Pereira, Catarina
Rubio-Rodríguez, Darío
Rubio-Terrés, Carlos
Sottomayor, Carlos
author_role author
author2 Gomes, Marília
Marques, Herlander
Pereira, Catarina
Rubio-Rodríguez, Darío
Rubio-Terrés, Carlos
Sottomayor, Carlos
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Carvalho, Susana
Gomes, Marília
Marques, Herlander
Pereira, Catarina
Rubio-Rodríguez, Darío
Rubio-Terrés, Carlos
Sottomayor, Carlos
description Introduction: To perform a cost-effectiveness analysis of follicular lymphoma maintenance treatment after first-line induction with rituximab compared to observation in Portugal.Methods: A Markov follicular lymphoma model was developed with four health states: progression free survival on first and second lines, progression and death. The transition probabilities between health states were obtained from the PRIMA and EORTC20981 clinical trials and the health states utilities from the literature. The analysis considered the Portuguese National Health Service perspective and includes only direct costs. Resource consumption was estimated by a Portuguese clinical expert panel. The unit costs (€ in 2014) were estimated using Portuguese official databases. Deterministic and probabilistic analyses were performed.Results: In the base case, for a time horizon of 10 years, the cost per life year gained and per quality-adjusted life-year were € 10,634 and € 10,664, respectively. The sensitivity analyses confirmed the stability of the base case for time horizons of 20 and 30 years, varying between € 7,430 and € 7,155. Maintenance with rituximab is cost-effective for a time horizon of 5.5 years (cost per quality-adjusted life-year gained of € 23,616).Conclusion: According to the present model rituximab maintenance treatment of follicular lymphoma patients that respond to first line induction therapy in comparison with observation is cost-effective in Portugal.
publishDate 2016
dc.date.none.fl_str_mv 2016-03-12
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv https://doi.org/10.25756/rpf.v8i1.90
https://doi.org/10.25756/rpf.v8i1.90
url https://doi.org/10.25756/rpf.v8i1.90
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv http://revista.farmacoterapia.pt/index.php/rpf/article/view/90
http://revista.farmacoterapia.pt/index.php/rpf/article/view/90/75
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2017 Revista Portuguesa de Farmacoterapia
http://creativecommons.org/licenses/by-nc-nd/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2017 Revista Portuguesa de Farmacoterapia
http://creativecommons.org/licenses/by-nc-nd/4.0
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dc.publisher.none.fl_str_mv Formifarma
publisher.none.fl_str_mv Formifarma
dc.source.none.fl_str_mv Revista Portuguesa de Farmacoterapia / Portuguese Journal of Pharmacotherapy; Vol 8 No 1 (2016): Janeiro; 17-26
Revista Portuguesa de Farmacoterapia; v. 8 n. 1 (2016): Janeiro; 17-26
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