Evidence map›Paper›PMID 37608228›Full record

ArticleApplied health economics and health policy2024

Cost Effectiveness of Molecular Diagnostic Testing Algorithms for the Treatment Selection of Frontline Ibrutinib for Patients with Chronic Lymphocytic Leukemia in Australia.

Martin Vu, Koen Degeling, Ella R Thompson, Piers Blombery, David Westerman, Maarten J IJzerman

Abstract read
In one paragraph

Article in Applied health economics and health policy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Martin VuCancer Health Services Research, Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 305 Grattan Street, Melbourne, VIC, 3000, Australia.ORCID 0000-0001-5918-1692
Koen DegelingCancer Health Services Research, Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 305 Grattan Street, Melbourne, VIC, 3000, Australia.ORCID 0000-0001-7487-2491
Ella R ThompsonPathology Department, Peter MacCallum Cancer Centre, Melbourne, Australia.ORCID 0000-0001-5206-5111
Piers BlomberyPathology Department, Peter MacCallum Cancer Centre, Melbourne, Australia.ORCID 0000-0002-9902-0022
David WestermanPathology Department, Peter MacCallum Cancer Centre, Melbourne, Australia.
Maarten J IJzermanCancer Health Services Research, Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 305 Grattan Street, Melbourne, VIC, 3000, Australia. maarten.ijzerman@unimelb.edu.au.ORCID 0000-0001-5788-5805

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical indications for ibrutinib reimbursement in Australia should consider the inclusion of patients with chronic lymphocytic leukemia (CLL) harboring prognostically unfavorable TP53/IGHV genomic aberrations. This study assessed the cost effectiveness of five first-line treatment strategies in CLL for young (aged ≤ 65 years), fit patients without significant comorbidities: (1) no testing (fludarabine, cyclophosphamide and rituximab [FCR] for all), (2) test for del(17p) only, (3) test for TP53 gene mutation status, (4) test for TP53 and IGHV gene mutation status and (5) no testing (ibrutinib for all).

methodA decision analytic model (decision tree and partitioned survival model) was developed from the Australian healthcare system perspective with a lifetime horizon. Comparative treatment effects were estimated from indirect treatment comparisons and survival analysis using several studies. Costs, utility and adverse events were derived from public literature sources. Deterministic and probabilistic sensitivity analyses explored the impact of modeling uncertainties on outcomes.

resultsStrategy 1 was associated with 5.69 quality-adjusted life-years (QALYs) and cost 458,836 Australian dollars (AUD). All other strategies had greater effectiveness but were more expensive than Strategy 1. At the willingness-to-pay (WTP) threshold of 100,000 AUD per QALY gained, Strategy 1 was most cost effective with an estimated probability of 68.8%. Strategy 4 was cost effective between thresholds 155,000-432,300 AUD per QALY gained, and Strategy 5 >432,300 AUD per QALY gained.

conclusionPopulation targeting using mutation testing for TP53 and IGHV when performed with del(17p) testing specifically in the context of frontline ibrutinib choice does not make a cost-ineffective treatment into a cost-effective treatment.

Indexed as

Leukemia, Lymphocytic, Chronic, B-CellAdenineAlgorithmsAustraliaCost-Benefit AnalysisCost-Effectiveness AnalysisHumansPiperidinesQuality-Adjusted Life YearsAdenineibrutinibPiperidines

Identifiers

PMID37608228
PMCPMC10761538

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.