Evaluación económica de rituximab en combinación con fludarabina y ciclofosfamida en comparación con fludarabina y ciclofosfamida en el tratamiento de la leucemia linfática crónica |
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Authors: | Luis Felipe CasadoJosé Antonio García Marco Florinda GilsanzMarcos González Eduardo RíosJavier de la Serna Álvaro UrbanoVicente Vicente Carlos Rubio-TerrésAntonio J Castro |
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Institution: | a Hospital Virgen de la Salud, Toledo, España b Hospital Universitario Puerta Hierro, Madrid, España c Hospital Universitario 12 de Octubre, Madrid, España d Hospital Clínico Universitario, Salamanca, España e Hospital Universitario Nuestra Señora de Valme, Sevilla, España f Hospital Universitario Virgen del Rocío, Sevilla, España g Hospital General Universitario, Murcia, España h Health Value, Madrid, España i Roche Farma, Madrid, España |
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Abstract: | ObjectivesWe evaluated the cost-effectiveness of rituximab added to the chemotherapy regimen of fludarabine plus cyclophosphamide (R-FC) versus fludarabine plus cyclophosphamide (FC) for the treatment of patients with previously untreated or relapsed/refractory chronic lymphocytic leukemia (CLL).MethodsTwo Markov models were built, using published results on progression-free survival (PFS) in patients receiving first- or second-line therapy with R-FC vs FC, rates of disease progression and mortality rates in Spain. Patient-elicited utilities were applied to PFS and progressed health states. The cost of drugs, supportive care, and quality-adjusted life years (QALY) were estimated over a 10-year period. Univariate and probabilistic (Monte Carlo) sensitivity analyses were performed.ResultsThe addition of rituximab to chemotherapy in first- and second-line therapy increased life-years gained (LYG) and QALYs compared with chemotherapy. The incremental cost per LYG and QALY gained was €20,703 and €19,343 for first-line treatment and was €23,183 and €24,781 for second-line treatment.ConclusionIn patients with previously untreated or relapsed/refractory CLL, the addition of rituximab to the FC regimen increased life expectancy and quality-adjusted life expectancy. In both types of patient, the treatment was cost-effective. |
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Keywords: | Leucemia linfá tica cró nica Rituximab Fludarabina Ciclofosfamida Coste-efectividad |
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