Abstract
BACKGROUND
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.
METHODS
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.
RESULTS
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).
CONCLUSIONS
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.