Cost-effectiveness of azacitidine and ivosidenib in newly diagnosed older, intensive chemotherapy-ineligible patients with IDH1-mutant acute myeloid leukemia. Issue 2 (28th January 2023)

• Record Type: Journal Article
• Authors: Bewersdorf, Jan Philipp; Patel, Kishan K.; Goshua, George; Shallis, Rory M.; Podoltsev, Nikolai A.; Stahl, Maximilian; Stein, Eytan M.; Huntington, Scott F.; Zeidan, Amer M.
• Is Part Of: Leukemia & lymphoma. Volume 64:Issue 2(2023)
• Page Start: 454
• Page End: 461
• Publication Date: 2023-01-28
• Subjects: Acute myeloid leukemia -- AML -- azacitidine -- ivosidenib -- cost-effectiveness; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2022.2140288
• Languages: English
• ISSNs: 1042-8194

Abstract

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.