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  1. Cost-effectiveness of interferon-alpha and conventional chemotherapy in chronic myelogenous leukemia.

    Article - En anglais

    Objective 

    To compare the cost-effectiveness of interferon-alpha with that of hydroxyurea as initial therapy for patients with chronic myelogenous leukemia (CML) in the chronic phase.

    Design 

    A decision analysis and Markov model that described the natural history of the therapeutic process.

    The Markov model contained two treatment arms (interferon-alpha and hydroxyurea) and eight states of health (complete hematologic remission with cytogenetic response, complete hematologic remission without cytogenetic response, partial hematologic remission, chronic phase without hematologic remission, accelerated phase, blast crisis, bone marrow transplantation, and death).

    Probabilities, costs, and utilities were obtained from published clinical studies and clinical investigators.

    Measurement 

    Quality-adjusted years of life saved and costs and qualities discounted at 5% per year.

    Setting 

    University medical centers in North America and Europe.

    Patients 

    Meta-analysis of results from patients studied in clinical trials.

    Results 

    The model's predictions of median survival (69 months with interferon-alpha therapy and 58 months with hydroxyurea therapy) were derived from data in the recent literature.

    In patients 50 years of age, interferon-alpha improved life expectancy over hydroxyurea by approximately 18 months. (...)

    Mots-clés Pascal : Leucémie myéloïde, Homme, Traitement, Chimiothérapie, Etude comparative, Interféron alpha, Immunothérapie, Hydroxycarbamide, Anticancéreux, Analyse coût efficacité, Economie santé, Analyse décision, Modèle Markov, Chronique, Hémopathie maligne, Myéloprolifératif syndrome, Cytokine

    Mots-clés Pascal anglais : Chronic myelocytic leukemia, Human, Treatment, Chemotherapy, Comparative study, Alpha interferon, Immunotherapy, Antineoplastic agent, Cost efficiency analysis, Health economy, Decision analysis, Markov model, Chronic, Malignant hemopathy, Myeloproliferative syndrome, Cytokine

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0464354

    Code Inist : 002B02R03. Création : 10/04/1997.