Economic evaluation of third-line treatment with alemtuzumab for chronic lymphocytic leukaemia.

OBJECTIVE The objective of this study was to compare the potential economic efficiency of third-line treatment of chronic lymphocytic leukaemia (CLL) with alemtuzumab versus fludarabine, cyclophosphamide and rituximab (FCR). METHODS The target population for this study were patients with CLL who were able to tolerate third-line treatment with either FCR or alemtuzumab. The perspective used was that of the New Zealand Pharmaceutical Management Agency (PHARMAC)/District Health Board. Health outcomes considered were survival time from commencement of treatment and quality-adjusted life-years (QALYs) gained. Average costs and outcomes and incremental cost per patient treated, per survival month and per QALY gained, were calculated. All costs were presented in 2006 New Zealand dollars. RESULTS Base-case direct medical costs for alemtuzumab per treatment regimen per patient were $NZ15 303 lower than those for FCR. The average direct medical cost per survival month gained for alemtuzumab was $NZ3144 and for FCR was $NZ4101, and the average direct medical cost per QALY gained was $NZ46,016 and for FCR was $NZ60,012. CONCLUSION Third-line treatment of eligible patients with alemtuzumab was found to be $NZ15,303 less costly than FCR per patient.