Cost-effectiveness of the regimen proposed by the International Consortium on Acute Promyelocytic Leukemia for the treatment of newly diagnosed patients with Acute Promyelocytic Leukemia

Introduction: We performed cost-effectiveness and cost-utility analyses of the modified International Consortium on Acute Promyelocytic Leukemia protocol in Mexico for the treatment of acute promyelocytic leukemia Acute Promyelocytic Leukemia. Methods: We performed a three-state Markov analysis: sta...

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Autores principales:	Sergio Rodríguez-Rodríguez, Lorena Guerrero-Torres, María José Díaz-Huízar, Alan Pomerantz, María del Pilar Ortíz-Vilchis, Roberta Demichelis-Gómez
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Acute promyelocytic leukemia All-trans retinoic acid IC-APL Cost-effectiveness Cost-utility Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/4c72fd642ea840eb991a6c563a8b24e9
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spelling	oai:doaj.org-article:4c72fd642ea840eb991a6c563a8b24e92021-11-04T04:37:22ZCost-effectiveness of the regimen proposed by the International Consortium on Acute Promyelocytic Leukemia for the treatment of newly diagnosed patients with Acute Promyelocytic Leukemia2531-137910.1016/j.htct.2020.08.013https://doaj.org/article/4c72fd642ea840eb991a6c563a8b24e92021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2531137920302844https://doaj.org/toc/2531-1379Introduction: We performed cost-effectiveness and cost-utility analyses of the modified International Consortium on Acute Promyelocytic Leukemia protocol in Mexico for the treatment of acute promyelocytic leukemia Acute Promyelocytic Leukemia. Methods: We performed a three-state Markov analysis: stable disease (first line complete response [CR]), disease event (relapse, second line response and CR) and death. The modified IC-APL protocol is composed of three phases: induction, consolidation and maintenance. Cost and outcomes were used to calculate incremental cost-effectiveness ratios (ICERs); quality-adjusted life-years were used to calculate incremental cost-utility ratios (ICURs). Results: The CR was achieved in 18 patients (90%), treated with the IC-APL protocol as the first-line option; one patient (5%) died in induction, another one never achieved CR (5%); of the 18 patients that achieved CR, 1 relapsed (5.5%). The median treatment cost of the IC-APL protocol was $21,523 USD. The average life-year in our study was 7.8 years, while the average quality-adjusted life-year (QALY) was 6.1 years. When comparing the ICER between the IC-APL and the all-trans retinoic acid (ATRA) plus arsenic trioxide (ATO) protocols, we found the different costs of $6497, $19,133 and $17,123 USD in Italy, the USA and Canada, respectively. In relation to the ICUR, we found the different costs to be $13,955 and $11,979 USD in the USA and Canada, respectively. Conclusion: Taking into account the similar response rates, lower cost and easy access to the modified IC-APL regimen, we consider it a cost-effective and cost-utility protocol, deeming it the treatment of choice for our population.Sergio Rodríguez-RodríguezLorena Guerrero-TorresMaría José Díaz-HuízarAlan PomerantzMaría del Pilar Ortíz-VilchisRoberta Demichelis-GómezElsevierarticleAcute promyelocytic leukemiaAll-trans retinoic acidIC-APLCost-effectivenessCost-utilityDiseases of the blood and blood-forming organsRC633-647.5ENHematology, Transfusion and Cell Therapy, Vol 43, Iss 4, Pp 476-481 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Acute promyelocytic leukemia All-trans retinoic acid IC-APL Cost-effectiveness Cost-utility Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	Acute promyelocytic leukemia All-trans retinoic acid IC-APL Cost-effectiveness Cost-utility Diseases of the blood and blood-forming organs RC633-647.5 Sergio Rodríguez-Rodríguez Lorena Guerrero-Torres María José Díaz-Huízar Alan Pomerantz María del Pilar Ortíz-Vilchis Roberta Demichelis-Gómez Cost-effectiveness of the regimen proposed by the International Consortium on Acute Promyelocytic Leukemia for the treatment of newly diagnosed patients with Acute Promyelocytic Leukemia
description	Introduction: We performed cost-effectiveness and cost-utility analyses of the modified International Consortium on Acute Promyelocytic Leukemia protocol in Mexico for the treatment of acute promyelocytic leukemia Acute Promyelocytic Leukemia. Methods: We performed a three-state Markov analysis: stable disease (first line complete response [CR]), disease event (relapse, second line response and CR) and death. The modified IC-APL protocol is composed of three phases: induction, consolidation and maintenance. Cost and outcomes were used to calculate incremental cost-effectiveness ratios (ICERs); quality-adjusted life-years were used to calculate incremental cost-utility ratios (ICURs). Results: The CR was achieved in 18 patients (90%), treated with the IC-APL protocol as the first-line option; one patient (5%) died in induction, another one never achieved CR (5%); of the 18 patients that achieved CR, 1 relapsed (5.5%). The median treatment cost of the IC-APL protocol was $21,523 USD. The average life-year in our study was 7.8 years, while the average quality-adjusted life-year (QALY) was 6.1 years. When comparing the ICER between the IC-APL and the all-trans retinoic acid (ATRA) plus arsenic trioxide (ATO) protocols, we found the different costs of $6497, $19,133 and $17,123 USD in Italy, the USA and Canada, respectively. In relation to the ICUR, we found the different costs to be $13,955 and $11,979 USD in the USA and Canada, respectively. Conclusion: Taking into account the similar response rates, lower cost and easy access to the modified IC-APL regimen, we consider it a cost-effective and cost-utility protocol, deeming it the treatment of choice for our population.
format	article
author	Sergio Rodríguez-Rodríguez Lorena Guerrero-Torres María José Díaz-Huízar Alan Pomerantz María del Pilar Ortíz-Vilchis Roberta Demichelis-Gómez
author_facet	Sergio Rodríguez-Rodríguez Lorena Guerrero-Torres María José Díaz-Huízar Alan Pomerantz María del Pilar Ortíz-Vilchis Roberta Demichelis-Gómez
author_sort	Sergio Rodríguez-Rodríguez
title	Cost-effectiveness of the regimen proposed by the International Consortium on Acute Promyelocytic Leukemia for the treatment of newly diagnosed patients with Acute Promyelocytic Leukemia
title_short	Cost-effectiveness of the regimen proposed by the International Consortium on Acute Promyelocytic Leukemia for the treatment of newly diagnosed patients with Acute Promyelocytic Leukemia
title_full	Cost-effectiveness of the regimen proposed by the International Consortium on Acute Promyelocytic Leukemia for the treatment of newly diagnosed patients with Acute Promyelocytic Leukemia
title_fullStr	Cost-effectiveness of the regimen proposed by the International Consortium on Acute Promyelocytic Leukemia for the treatment of newly diagnosed patients with Acute Promyelocytic Leukemia
title_full_unstemmed	Cost-effectiveness of the regimen proposed by the International Consortium on Acute Promyelocytic Leukemia for the treatment of newly diagnosed patients with Acute Promyelocytic Leukemia
title_sort	cost-effectiveness of the regimen proposed by the international consortium on acute promyelocytic leukemia for the treatment of newly diagnosed patients with acute promyelocytic leukemia
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/4c72fd642ea840eb991a6c563a8b24e9
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Cost-effectiveness of the regimen proposed by the International Consortium on Acute Promyelocytic Leukemia for the treatment of newly diagnosed patients with Acute Promyelocytic Leukemia

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