Cost-Effectiveness of Extracorporeal Photopheresis in Patients With Chronic Graft-vs-Host Disease
- Author(s)
- Peacock, A; Dehle, FC; Mesa Zapata, OA; Gennari, F; Williams, MRI; Hamad, N; Larsen, S; Harrison, SJ; Taylor, C;
- Details
- Publication Year 2024,Volume 11,Issue #1,Page 23-31
- Journal Title
- Journal of Health Economics and Outcomes Research
- Publication Type
- Research article
- Abstract
- Background: The mainstay first-line therapy for chronic graft-vs-host disease (cGVHD) is corticosteroids; however, for steroid-refractory patients, there is a distinct lack of cost-effective or efficacious treatment. The aim of this study was to assess the cost-effectiveness of extracorporeal photopheresis (ECP) compared with standard-of-care therapies for the treatment of cGVHD in Australia. The study formed part of an application to the Australian Government to reimburse ECP for these patients. Methods: A cost-utility analysis was conducted comparing ECP to standard of care, which modeled the response to treatment and disease progression of cGVHD patients in Australia. Mycophenolate, tacrolimus, and cyclosporin comprised second-line standard of care based on a survey of Australian clinicians. Health states in the model included treatment response, disease progression, and death. Transition probabilities were obtained from Australian-specific registry data and randomized controlled evidence. Quality-of-life values were applied based on treatment response. The analysis considered costs of second-line treatment and disease management including immunosuppressants, hospitalizations and subsequent therapy. Disease-specific mortality was calculated for treatment response and progression. Results: Over a 10-year time horizon, ECP resulted in an average cost reduction of $23 999 and an incremental improvement of 1.10 quality-adjusted life-years per patient compared with standard of care. The sensitivity analysis demonstrated robustness over a range of plausible scenarios. Conclusion: This analysis demonstrates that ECP improves quality of life, minimizes the harms associated with immunosuppressant therapy, and is a highly cost-effective option for steroid-refractory cGVHD patients in Australia. Based in part on this analysis, ECP was listed on the Medicare Benefits Schedule for public reimbursement.
- Publisher
- Columbia Data Analytics
- Keywords
- cost-effectiveness analysis; cost-utility analysis; extracorporeal photopheresis; graft-vs-host disease; health technology assessment
- Department(s)
- Clinical Haematology
- Publisher's Version
- https://doi.org/10.36469/001c.92028
- Open Access at Publisher's Site
https://doi.org/10.36469/001c.92028- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-03-13 05:11:32
Last Modified: 2024-03-13 05:25:38