Resource utilization and cost effectiveness of treating acute promyelocytic leukaemia using generic arsenic trioxide

Bankar, Aniket ; Korula, Anu ; Kulkarni, Uday P. ; Devasia, Anup J. ; NA, Fouzia ; Lionel, Sharon ; Abraham, Aby ; Balasubramanian, Poonkuzhali ; Janet, Nancy Beryl ; Nair, Sukesh C. ; S, Sezlian ; Jeyaseelan, Visali ; N, Jeyaseelan ; Prasad, Jasmine ; George, Biju ; Mathews, Vikram (2020) Resource utilization and cost effectiveness of treating acute promyelocytic leukaemia using generic arsenic trioxide British Journal of Haematology, 189 (2). pp. 269-278. ISSN 0007-1048

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Official URL: http://doi.org/10.1111/bjh.16343

Related URL: http://dx.doi.org/10.1111/bjh.16343

Abstract

Arsenic trioxide (ATO)-based regimens are the standard of care for treating acute promyelocytic leukaemia (APL) and have replaced chemotherapy-based approaches. However, the cost of "patented" ATO is prohibitive because of patent rights. "Generic" ATO has been used in a few countries, but its implications for health resource utilization (HRU) and cost of treatment are unknown. We hypothesized that treating APL patients using generic ATO (APL-ATO) will be cost effective compared to the chemotherapy-based regimen (APL-CT). In a single-centre retrospective study, we used a bottom-up costing method to compare the direct medical cost of treatment and HRU between APL-ATO and APL-CT. These costs and the survival and relapse probabilities were imputed in a three-state Markov decision model to estimate the cost effectiveness of APL-ATO compared to APL-CT. The mean cost of treatment for APL-ATO (n = 30, $8500 ± 2078) was significantly less than for APL-CT (n = 30, $22 600 ± 5528) (P < 0·001). APL-ATO reduced hospitalization, antibiotic and antifungal usage (P < 0·001). In the Markov model, five-year treatment costs were significantly lower for APL-ATO ($11 131) than for APL-CT ($17 926) (P < 0·001). Treatment cost and health resource utilization were significantly lower for generic ATO-treated APL patients compared to the chemotherapy-based regimen.

Item Type:Article
Source:Copyright of this article belongs to British Society for Haematology.
ID Code:124105
Deposited On:03 Nov 2021 13:03
Last Modified:03 Nov 2021 13:03

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