Evaluación económica de rituximab en combinación con udarabina y ciclofosfamida en comparación con udarabina y ciclofosfamida en el tratamiento de la leucemia linfática crónica

Objectives: We evaluated the cost-effectiveness of rituximab added to the chemotherapy regimen of ”udarabine plus cyclophosphamide (R-FC) versus ”udarabine plus cyclophosphamide (FC) for the treatment of patients with previously untreated or relapsed/refractory chronic lymphocytic leukemia (CLL). Methods: Two Markov models were built, using published results on progression-free survival (PFS) in patients receiving “rst- or second-line therapy with R-FC vs FC, rates of disease progression and mortality rates in Spain. Patient-elicited utilities were applied to PFS and progressed health states. The cost of drugs, supportive care, and quality-adjusted life years (QALY) were estimated over a 10-year period. Univariate and probabilistic (Monte Carlo) sensitivity analyses were performed. Results: The addition of rituximab to chemotherapy in “rst- and second-line therapy increased lifeyears gained (LYG) and QALYs compared with chemotherapy. The incremental cost per LYG and QALY gained wasD 20,703 andD 19,343 for “rst-line treatment and was D 23,183 andD 24,781 for second-line treatment.