Cost Effectiveness of Imatinib Mesylate in the Treatment of Advanced Gastrointestinal Stromal Tumours
- PDF / 120,922 Bytes
- 9 Pages / 504.57 x 720 pts Page_size
- 94 Downloads / 190 Views
ORIGINAL RESEARCH ARTICLE
© 2007 Adis Data Information BV. All rights reserved.
Cost Effectiveness of Imatinib Mesylate in the Treatment of Advanced Gastrointestinal Stromal Tumours Daniel M. Huse,1 Margaret von Mehren,2 Gregory Lenhart,1 Heikki Joensuu,3 Charles Blanke,4 Weiwei Feng,5 Stan Finkelstein6 and George Demetri7 1 2 3 4 5 6 7
Thomson Medstat, Cambridge, Massachusetts, USA Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA Department of Oncology, Helsinki University, Helsinki University Central Hospital, Helsinki, Finland The Oregon Health and Science University Cancer Institute, Portland, Oregon, USA Novartis Pharmaceuticals Corporation, Oncology, Florham Park, New Jersey, USA MIT Sloan School of Management, Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, USA Dana-Farber Cancer Institute, Center for Sarcoma and Bone Oncology, Boston, Massachusetts, USA
Abstract
Background and objective: Imatinib mesylate is the first effective therapy for advanced unresectable gastrointestinal stromal tumours (GIST). Adoption of this therapy in clinical practice is partly dependent on reimbursement by third-party payers in many countries. The objective of this study was to estimate the cost effectiveness of imatinib mesylate in the treatment of GIST. Methods: A cost-effectiveness model of GIST treatment was developed. Longterm survival and duration of imatinib mesylate benefit were projected by fitting curves to 52-month follow-up data from a phase II clinical trial of imatinib and projecting weekly probabilities of survival and continued treatment over 10 years. Weekly cost estimates in 2005 US dollars included cost of imatinib mesylate 400 mg/day ($US685), other medical services for imatinib mesylate-treated patients ($US359) and palliative care for patients in the end stage of GIST ($US2575). Utility associated with successful treatment was estimated at 0.935 and that of treatment failure and progressive disease at 0.875. Costs, life-years and qualityadjusted life-years (QALYs) were calculated over the 10-year time horizon and discounted to treatment initiation at an annual rate of 3%. Results: Imatinib mesylate therapy for unresectable GIST was projected to increase life expectancy to 5.8 years, an increase of 2.7 years over the control
86
Huse et al.
group. This translated into an increase of 1.9 QALYs at a marginal cost of $US74 369, yielding a cost-effectiveness ratio of $US38 723 per QALY. Cost effectiveness was not very sensitive to model parameters other than the cost of imatinib mesylate itself. Conclusion: The cost effectiveness of imatinib mesylate in the treatment of GIST is within the commonly accepted range for life-saving interventions, based on US data.
Introduction Gastrointestinal stromal tumours (GIST) are softtissue tumours of the gastrointestinal tract, most commonly of gastric origin, that express the activated transmembrane kit receptor that leads to dysfunctional tyrosine kinase activity.[1-4] These tumours are ini
Data Loading...
