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Cost‐effectiveness analysis of early vs. late autologous stem cell transplantation in multiple myeloma
Author(s) -
Pandya Chintan,
Hashmi Shahrukh,
Khera Nandita,
Gertz Morie A.,
Dispenzieri Angela,
Hogan William,
Siddiqui Mustaqeem,
Noyes Katia,
Kumar Shaji K.
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12421
Subject(s) - medicine , multiple myeloma , cohort , autologous stem cell transplantation , oncology , transplantation , quality adjusted life year , quality of life (healthcare) , cost effectiveness , surgery , intensive care medicine , risk analysis (engineering) , nursing
Background Autologous stem cell transplant ( ASCT ) is the current standard of care for most patients with multiple myeloma (MM) who are transplant eligible, yet the timing of ASCT is disputed due to a similar overall (OS) and progression‐free survival with an early ASCT ( eASCT ) or a delayed ASCT ( dASCT ) approach. Objective We developed a decision analytic model to perform cost‐effectiveness analysis of the two commonly used treatment strategies for MM . Methods Data on disease progression and treatment effectiveness came from 2001 to 2008 cohort treated at the Mayo Clinic and from published studies. Cost analysis was performed from a third‐party payer perspective. Results The Consumer Price Index adjusted 2012 costs of eASCT and dASCT were $249 236 and $262 610, respectively. eASCT cohort had a benefit of 1.96 quality‐adjusted life years (QALYs), 0.23 QALYs more than dASCT , implying that eASCT is preferred (dominant) over dASCT . The most critical variables in one‐way sensitivity analysis were treatment‐related mortality and OS associated with eASCT strategy. Conclusions We conclude that eASCT could potentially be a relatively cost‐effective treatment option for appropriate patients with MM, and these results would help patients, providers, and payers in decision making for timing of ASCT.