Long term evaluation of the impact of autologous peripheral blood stem cell transplantation in multiple myeloma: a cost-effectiveness analysis.

<h4>Background</h4>High-dose therapy with autologous peripheral stem cell transplantation represents today the standard approach for younger multiple myeloma patients. This study aimed to evaluate the long term economic impact of autologous transplantation with respect to conventional th...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Alessandro Corso, Silvia Mangiacavalli, Federica Cocito, Cristiana Pascutto, Virginia Valeria Ferretti, Alessandra Pompa, Roberta Ciampichini, Lara Pochintesta, Lorenzo G Mantovani
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f3b0bcfe1bba45f9a3a34c2ed10fa6d6
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:f3b0bcfe1bba45f9a3a34c2ed10fa6d6
record_format	dspace
spelling	oai:doaj.org-article:f3b0bcfe1bba45f9a3a34c2ed10fa6d62021-11-18T08:53:09ZLong term evaluation of the impact of autologous peripheral blood stem cell transplantation in multiple myeloma: a cost-effectiveness analysis.1932-620310.1371/journal.pone.0075047https://doaj.org/article/f3b0bcfe1bba45f9a3a34c2ed10fa6d62013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24098678/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>High-dose therapy with autologous peripheral stem cell transplantation represents today the standard approach for younger multiple myeloma patients. This study aimed to evaluate the long term economic impact of autologous transplantation with respect to conventional therapy.<h4>Methods</h4>We retrospectively reviewed the charts of multiple myeloma patients diagnosed at our department between 1986 and 2003 and treated according to the therapy considered standard at the time of diagnosis. Analysis of costs was done by assessing resource utilization and direct costs were measured and monetized before proceeding with the analysis, based on public health service tariffs.<h4>Results</h4>Group A including 78 patients treated with Melphalan and Prednisone was compared with Group B including 74 patients who received an autologous transplant. The median overall survival was 3.2 and 5.4 years respectively (p = 0.0002). Mean cost per patient was significantly higher in group B with respect to group A (102373€ vs 23825€; p<0.001). The final quality-adjusted-life-year gain in group B patients as compared to group A was 1.73 QALY, with an incremental cost-effectiveness ratio of 45460€. With a threshold of 75000€ per QALY gained, the cost effectiveness acceptability curve indicated that the probability that autologous transplantation in multiple myeloma is a cost-effective intervention is 90%.<h4>Conclusions</h4>The cost of autologous transplantation remains high. The calculated incremental cost-effectiveness ratio, however, given the significant prolongation of overall survival obtained with autologous transplantation, is within an acceptable threshold. Notwithstanding, its high cost should be taken into account when considering the whole cost of multiple myeloma.Alessandro CorsoSilvia MangiacavalliFederica CocitoCristiana PascuttoVirginia Valeria FerrettiAlessandra PompaRoberta CiampichiniLara PochintestaLorenzo G MantovaniPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 9, p e75047 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Alessandro Corso Silvia Mangiacavalli Federica Cocito Cristiana Pascutto Virginia Valeria Ferretti Alessandra Pompa Roberta Ciampichini Lara Pochintesta Lorenzo G Mantovani Long term evaluation of the impact of autologous peripheral blood stem cell transplantation in multiple myeloma: a cost-effectiveness analysis.
description	<h4>Background</h4>High-dose therapy with autologous peripheral stem cell transplantation represents today the standard approach for younger multiple myeloma patients. This study aimed to evaluate the long term economic impact of autologous transplantation with respect to conventional therapy.<h4>Methods</h4>We retrospectively reviewed the charts of multiple myeloma patients diagnosed at our department between 1986 and 2003 and treated according to the therapy considered standard at the time of diagnosis. Analysis of costs was done by assessing resource utilization and direct costs were measured and monetized before proceeding with the analysis, based on public health service tariffs.<h4>Results</h4>Group A including 78 patients treated with Melphalan and Prednisone was compared with Group B including 74 patients who received an autologous transplant. The median overall survival was 3.2 and 5.4 years respectively (p = 0.0002). Mean cost per patient was significantly higher in group B with respect to group A (102373€ vs 23825€; p<0.001). The final quality-adjusted-life-year gain in group B patients as compared to group A was 1.73 QALY, with an incremental cost-effectiveness ratio of 45460€. With a threshold of 75000€ per QALY gained, the cost effectiveness acceptability curve indicated that the probability that autologous transplantation in multiple myeloma is a cost-effective intervention is 90%.<h4>Conclusions</h4>The cost of autologous transplantation remains high. The calculated incremental cost-effectiveness ratio, however, given the significant prolongation of overall survival obtained with autologous transplantation, is within an acceptable threshold. Notwithstanding, its high cost should be taken into account when considering the whole cost of multiple myeloma.
format	article
author	Alessandro Corso Silvia Mangiacavalli Federica Cocito Cristiana Pascutto Virginia Valeria Ferretti Alessandra Pompa Roberta Ciampichini Lara Pochintesta Lorenzo G Mantovani
author_facet	Alessandro Corso Silvia Mangiacavalli Federica Cocito Cristiana Pascutto Virginia Valeria Ferretti Alessandra Pompa Roberta Ciampichini Lara Pochintesta Lorenzo G Mantovani
author_sort	Alessandro Corso
title	Long term evaluation of the impact of autologous peripheral blood stem cell transplantation in multiple myeloma: a cost-effectiveness analysis.
title_short	Long term evaluation of the impact of autologous peripheral blood stem cell transplantation in multiple myeloma: a cost-effectiveness analysis.
title_full	Long term evaluation of the impact of autologous peripheral blood stem cell transplantation in multiple myeloma: a cost-effectiveness analysis.
title_fullStr	Long term evaluation of the impact of autologous peripheral blood stem cell transplantation in multiple myeloma: a cost-effectiveness analysis.
title_full_unstemmed	Long term evaluation of the impact of autologous peripheral blood stem cell transplantation in multiple myeloma: a cost-effectiveness analysis.
title_sort	long term evaluation of the impact of autologous peripheral blood stem cell transplantation in multiple myeloma: a cost-effectiveness analysis.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/f3b0bcfe1bba45f9a3a34c2ed10fa6d6
work_keys_str_mv	AT alessandrocorso longtermevaluationoftheimpactofautologousperipheralbloodstemcelltransplantationinmultiplemyelomaacosteffectivenessanalysis AT silviamangiacavalli longtermevaluationoftheimpactofautologousperipheralbloodstemcelltransplantationinmultiplemyelomaacosteffectivenessanalysis AT federicacocito longtermevaluationoftheimpactofautologousperipheralbloodstemcelltransplantationinmultiplemyelomaacosteffectivenessanalysis AT cristianapascutto longtermevaluationoftheimpactofautologousperipheralbloodstemcelltransplantationinmultiplemyelomaacosteffectivenessanalysis AT virginiavaleriaferretti longtermevaluationoftheimpactofautologousperipheralbloodstemcelltransplantationinmultiplemyelomaacosteffectivenessanalysis AT alessandrapompa longtermevaluationoftheimpactofautologousperipheralbloodstemcelltransplantationinmultiplemyelomaacosteffectivenessanalysis AT robertaciampichini longtermevaluationoftheimpactofautologousperipheralbloodstemcelltransplantationinmultiplemyelomaacosteffectivenessanalysis AT larapochintesta longtermevaluationoftheimpactofautologousperipheralbloodstemcelltransplantationinmultiplemyelomaacosteffectivenessanalysis AT lorenzogmantovani longtermevaluationoftheimpactofautologousperipheralbloodstemcelltransplantationinmultiplemyelomaacosteffectivenessanalysis
_version_	1718421238876995584

Long term evaluation of the impact of autologous peripheral blood stem cell transplantation in multiple myeloma: a cost-effectiveness analysis.

Ejemplares similares