Cost-Effectiveness Analysis of Nilotinib Versus Dasatinib as Second-Line Treatment of Chronic Myeloid Leukemia

Ling MA; Yanhong ZHAO; Jia LIU; Wenlian TU

doi:10.12259/j.issn.2095-610X.S20240413

Volume 45 Issue 4

Apr. 2024

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Article Navigation > Journal of Kunming Medical University > 2024 > 45(4): 92-98

Ling MA, Yanhong ZHAO, Jia LIU, Wenlian TU. Cost-Effectiveness Analysis of Nilotinib Versus Dasatinib as Second-Line Treatment of Chronic Myeloid Leukemia[J]. Journal of Kunming Medical University, 2024, 45(4): 92-98. doi: 10.12259/j.issn.2095-610X.S20240413

Citation:

Ling MA, Yanhong ZHAO, Jia LIU, Wenlian TU. Cost-Effectiveness Analysis of Nilotinib Versus Dasatinib as Second-Line Treatment of Chronic Myeloid Leukemia[J]. Journal of Kunming Medical University, 2024, 45(4): 92-98. doi: 10.12259/j.issn.2095-610X.S20240413

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Cost-Effectiveness Analysis of Nilotinib Versus Dasatinib as Second-Line Treatment of Chronic Myeloid Leukemia

doi: 10.12259/j.issn.2095-610X.S20240413

1.
Dept. of Clinnical Pharmacy，The 1st People’s Hospital of Yunnan Province/ The Affiliated Hospital of Kunming University of Science and Technology/ Clinical pharmacy Center of Yunnan Province ，Kunming Yunnan 650032
2.
School of Pharmaceutical Sciences，Kunming Medical University，Kunming Yunnan 650500，China

Received Date: 2023-12-20
Available Online: 2024-04-06
Publish Date: 2024-04-29

Abstract

Abstract

Objective To evaluate the cost-effectiveness of nilotinib versus dasatinib in the second-line treatment of Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase. Methods Establish a Markov model for cost-effectiveness analysis, including four health states: chronic phase （CP）, accelerated phase （AP）, blast phase （BP）, and death. Clinical parameters related to progression-free survival rates, disease progression rates, overall survival rates, etc. for treatment with nilotinib and dasatinib are derived from previously published studies and expert opinions, while health state utility values are sourced from the literature. Using Treeage software, the incremental cost-effectiveness ratio （ICER） was used as an evaluation metric to assess the total output and total costs of the two schemes of nilotinib and dasatinib, and model stability is evaluated through univariate and probabilistic sensitivity analyses. Results Compared with using dasatinib for treatment, the ICER for using nilotinib treatment is 182487.71 yuan per QALY, which is less than 3 times the national per capita GDP in 2021. Sensitivity analysis showed that the main influencing parameters are the discount rate, dasatinib price, and nilotinib price, and the model results are stable. Conclusion Nilotinib has a cost-utility advantage over dasatinib in the treatment of Ph+CML-CP patients who are resistant or intolerent to imatinib.
- Nilotinib,
- Dasatinib,
- Chronic myeloid leukemia,
- Cost-effectiveness analysis,
- Second-line treatment

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References(22)

References

[1]	中华医学会血液学分会. 慢性髓性白血病中国诊断与治疗指南(2020年版)[J]. 中华血液学杂志,2020,(5):353-364. doi: 10.3760/cma.j.issn.0253-2727.2020.05.001
[2]	Morel F,Ka C,Le Bris MJ,et al. Deletion of the 5' abl region in Philadelphia chromosome-positive chronic myeloid leukemia[J]. Leukemia,2003,17(2):473-474. doi: 10.1038/sj.leu.2402816
[3]	Melo J V. The diversity of BCR-ABL fusion proteins and their relationship to leukemia phenotype[J]. Blood,1996,88(7):2375-2384. doi: 10.1182/blood.V88.7.2375.bloodjournal8872375
[4]	Baccarani M,Cortes J,Pane F,et al. Chronic myeloid leukemia: An update of concepts and management recommendations of European Leukemia Net[J]. J Clin Oncol,2009,27(35):6041-6051. doi: 10.1200/JCO.2009.25.0779
[5]	Mace M L,Dahl J,Jabbour E J. Which tyrosine-kinase inhibitor to use first in chronic phase chronic myelogenous leukemia?[J]. Expert Opin Pharmacother,2015,16(7):999-1007.
[6]	Radich J P, Deininger M, Abboud C N, et al. NCCN clinical practice guidelines in oncology: Chronic myelogenous leukemia (2023, Version 1) [M/OL]. [2023-1-23]. https://www.nccn.org//login?ReturnURL=https://www.nccn.org/professionals/physician_gls/pdf/cml.pdf
[7]	陈琳,杨敏,程国华. 尼洛替尼与达沙替尼二线治疗慢性髓系白血病的药物经济学评价[J]. 肿瘤,2016,36(6):698-704,710.
[8]	徐伟,高楠,马丽,等. 大剂量伊马替尼、达沙替尼和尼洛替尼治疗慢性髓性白血病的成本效用分析[J]. 中国医院药学杂志,2017,37(19):1974-1978.
[9]	Bonifacio M,Maheshwari V,Tran D,et al. Economic model to evaluate the cost-effectiveness of second-line nilotinib versus dasatinib for the treatment of Philadelphia chromosome-positive chronic myeloid leukemia (CML-CP) in Italy[J]. Pharmacoecon Open,2022,6(1):95-104. doi: 10.1007/s41669-021-00286-3
[10]	Li N,Yang X,Fan L,et al. Nilotinib versus dasatinib as second-line therapy in patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase who are resistant or intolerant to imatinib: A cost-effectiveness analysis based on real-world data[J]. J Med Econ,2017,20(4):328-336. doi: 10.1080/13696998.2016.1261032
[11]	Yue X,Hincapie A L,Li Y,et al. Safety and cost-effectiveness of ponatinib versus other tyrosine kinase inhibitors as second-line therapy in patients with chronic myeloid leukemia in the United States[J]. Leuk Lymphoma,2022,63(4):946-954. doi: 10.1080/10428194.2021.2002320
[12]	Giles F J,Coutre P D L,Pinilla-Ibarz J,et al. Nilotinib in imatinib-resistant or imatinib-intolerant patients with chronic myeloid leukemia in chronic phase: 48-month follow-up results of a phase II study[J]. Leukemia,2013,27(1):107-112. doi: 10.1038/leu.2012.181
[13]	Shah N P,Kim D W,Kantarjian H M,et al. Potent transient inhibition of BCR-ABL with dasatinib 100 mg daily achieves rapid and durable cytogenetic responses and high transformation-free survival rates in chronic phase chronic myeloid leukemia patients with resistance,suboptimal response or into[J]. Heamatologica,2010,95(2):232-240. doi: 10.3324/haematol.2009.011452
[14]	Griffin J D,Guerin A,Chen L,et al. Comparing nilotinib with dasatinib as second-line therapies in patients with chronic myelogenous leukemia resistant or intolerant to imatinib - a retrospective chart review analysis[J]. Curr Med Res Opin,2013,29(6):623-631. doi: 10.1185/03007995.2013.789012
[15]	Shah N P,Guilhot F,Cortes J E,et al. Long-term outcome with dasatinib after imatinib failure in chronic-phase chronic myeloid leukemia: Follow-up of a phase 3 study[J]. Blood,2014,123(15):2317-2324. doi: 10.1182/blood-2013-10-532341
[16]	Kulpeng W,Sompitak S,Jootar S,et al. Cost-utility analysis of dasatinib and nilotinib in patients with chronic myeloid leukemia refractory to first-line treatment with imatinib in Thailand[J]. Clin Ther,2014,36(4):534-543.
[17]	Huang X,Jiang Q,Hu J,et al. Four-year follow-up of patients with imatinib-resistant or intolerant chronic myeloid leukemia receiving dasatinib: Efficacy and safety[J]. Front Med,2018,13(3):344-353.
[18]	Padula W V,Larson R A,Dusetzina S B,et al. Cost-effectiveness of tyrosine kinase inhibitor treatment strategies for chronic myeloid leukemia in chronic phase after generic entry of imatinib in the United States[J]. J Natl Cancer Inst,2016,108(7):djw003. doi: 10.1093/jnci/djw003
[19]	刘国恩. 中国药物经济学评价指南（2020中英双语版）[M]. 北京: 中国市场出版社, 2020: 27-47.
[20]	Nguyen J T,Cole A L,Leech A A,et al. Cost-effectiveness of first-line tyrosine kinase inhibitor therapy initiation strategies for chronic myeloid leukemia[J]. Value Health,2020,23(10):1292-1299. doi: 10.1016/j.jval.2020.05.019
[21]	Li N,Zheng B,Cai H F. et al. Cost effectiveness of imatinib,dasatinib,and nilotinib as first-line treatment for chronic-phase chronic myeloid leukemia in china[J]. Clin Drug Investig,2018,38(1):79-86. doi: 10.1007/s40261-017-0587-z
[22]	Cai D,Shi S,Jiang S,et al. Estimation of the cost-effective threshold of a quality-adjusted life year in China based on the value of statistical life[J]. Eur J Health Econ,2022,23(4):607-615. doi: 10.1007/s10198-021-01384-z

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