Drs. Reed and Schulman have served as consultants for Novartis Pharmaceuticals Corporation.
Article first published online: 18 OCT 2004
Copyright © 2004 American Cancer Society
Volume 101, Issue 11, pages 2574–2583, 1 December 2004
How to Cite
Reed, S. D., Anstrom, K. J., Ludmer, J. A., Glendenning, G. A. and Schulman, K. A. (2004), Cost-effectiveness of imatinib versus interferon-α plus low-dose cytarabine for patients with newly diagnosed chronic-phase chronic myeloid leukemia. Cancer, 101: 2574–2583. doi: 10.1002/cncr.20694
See accompanying article on pages 2584–92, this issue.
Portions of this study were presented at the 44th Annual Meeting of the American Society for Hematology, December 6–10, 2002, Philadelphia, Pennsylvania, and at the 45th Annual Meeting of the American Society for Hematology, December 6–9, 2003, San Diego, California.
- Issue published online: 16 NOV 2004
- Article first published online: 18 OCT 2004
- Manuscript Accepted: 20 JUL 2004
- Manuscript Received: 15 JUN 2004
- Duke University Medical Center
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
- clinical trials;
- cost-benefit analysis;
- chronic myeloid leukemia;
- survival analysis
Despite a lack of long-term data, imatinib has become standard therapy for patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML) who are not candidates for allogeneic stem cell transplantation. In the current study, the authors estimated the incremental cost-effectiveness of imatinib versus interferon-α plus low-dose cytarabine (IFN+LDAC) as first-line therapy for these patients.
Data from the International Randomized Interferon versus STI571 Study and the literature were used to estimate lifetime costs, survival, and quality-adjusted survival. Survival estimates were based on published survival curves for patients who achieved and those who did not achieve a complete cytogenetic response after treatment with interferon-α.
The mean estimated survival with first-line imatinib therapy was 15.30 years, compared with 9.07 years with IFN+LDAC. Undiscounted lifetime costs were approximately $424,600 with imatinib and $182,800 with IFN+LDAC. Using a 3% discount rate, the incremental survival gain with imatinib was 3.93 life-years and 3.89 quality-adjusted life-years (QALYs). Incremental discounted lifetime costs were found to be $168,100 higher with imatinib, resulting in incremental cost-effectiveness ratios of $43,100 per life-year saved (95% confidence interval [95% CI], $37,600–51,100) and $43,300 per QALY (95% CI, $38,300–49,100).
The results of the current study demonstrate that compared with IFN+LDAC, imatinib is a cost-effective first-line therapy in patients with newly diagnosed chronic-phase CML. Cancer 2004. © 2004 American Cancer Society.