Cost-effectiveness of azacitidine and ivosidenib in newly diagnosed older, intensive chemotherapy-ineligible patients with IDH1-mutant acute myeloid leukemia Journal Article
| Authors: | Bewersdorf, J. P.; Patel, K. K.; Goshua, G.; Shallis, R. M.; Podoltsev, N. A.; Stahl, M.; Stein, E. M.; Huntington, S. F.; Zeidan, A. M. |
| Article Title: | Cost-effectiveness of azacitidine and ivosidenib in newly diagnosed older, intensive chemotherapy-ineligible patients with IDH1-mutant acute myeloid leukemia |
| Abstract: | Ivosidenib + azacitidine (IVO/AZA) is approved in the United States for newly diagnosed, older or intensive chemotherapy-ineligible patients with IDH1-mutated acute myeloid leukemia. We created a partitioned survival analysis model to evaluate the health economic implications of this approval. Model outputs were used to calculate the incremental cost-effectiveness ratio (ICER) of IVO/AZA versus AZA. One-way and probabilistic sensitivity analyses were conducted. In the base case scenario, IVO/AZA and AZA resulted in life-time costs of $403,062 and $161,887, respectively. With an incremental gain of 0.95 QALYs, the ICER of IVO/AZA was $252,782/QALY. In sensitivity analyses, only a reduction in the price of IVO by 59.3% lowered the ICER to below $150,000/QALY and 99.95% of model calculations yielded ICERs of >$150,000/QALY. In a model in which all patients received IVO monotherapy after progression on AZA monotherapy, the ICER was $155,453/QALY and various model inputs that would make IVO/AZA cost-effective were identified. © 2022 Informa UK Limited, trading as Taylor & Francis Group. |
| Keywords: | genetics; leukemia, myeloid, acute; pyridines; united states; quality adjusted life year; cost-benefit analysis; cost-effectiveness; azacitidine; cost benefit analysis; pyridine derivative; quality-adjusted life years; isocitrate dehydrogenase; aml; acute myeloid leukemia; idh1 protein, human; humans; human; ivosidenib |
| Journal Title: | Leukemia and Lymphoma |
| Volume: | 64 |
| Issue: | 2 |
| ISSN: | 1042-8194 |
| Publisher: | Taylor & Francis Group |
| Date Published: | 2023-01-01 |
| Start Page: | 454 |
| End Page: | 461 |
| Language: | English |
| DOI: | 10.1080/10428194.2022.2140288 |
| PUBMED: | 36493798 |
| PROVIDER: | scopus |
| PMCID: | PMC9957935 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Source: Scopus |
