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Gemcitabine/dexamethasone/cisplatin vs cytarabine/dexamethasone/cisplatin for relapsed or refractory aggressive-histology lymphoma: cost-utility analysis of NCIC CTG LY.12

The NCIC CTG LY.12 study showed that gemcitabine, dexamethasone, and cisplatin (GDP) were noninferior to dexamethasone, cytarabine, and cisplatin (DHAP) in patients with relapsed or refractory aggressive histology lymphoma prior to autologous stem cell transplantation. We conducted an economic evalu... Full description

Journal Title: Journal of the National Cancer Institute July 2015, Vol.107(7)
Main Author: Cheung, Matthew C
Other Authors: Hay, Annette E , Crump, Michael , Imrie, Kevin R , Song, Yuyao , Hassan, Shazia , Risebrough, Nancy , Sussman, Jonathan , Couban, Stephen , Macdonald, David , Kukreti, Vishal , Kouroukis, C Tom , Baetz, Tara , Szwajcer, David , Desjardins, Pierre , Shepherd, Lois , Meyer, Ralph M , Le, Al , Chen, Bingshu E , Mittmann
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: E-ISSN: 1460-2105 ; PMID: 25868579 Version:1 ; DOI: 10.1093/jnci/djv106
Link: http://pubmed.gov/25868579
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title: Gemcitabine/dexamethasone/cisplatin vs cytarabine/dexamethasone/cisplatin for relapsed or refractory aggressive-histology lymphoma: cost-utility analysis of NCIC CTG LY.12
format: Article
creator:
  • Cheung, Matthew C
  • Hay, Annette E
  • Crump, Michael
  • Imrie, Kevin R
  • Song, Yuyao
  • Hassan, Shazia
  • Risebrough, Nancy
  • Sussman, Jonathan
  • Couban, Stephen
  • Macdonald, David
  • Kukreti, Vishal
  • Kouroukis, C Tom
  • Baetz, Tara
  • Szwajcer, David
  • Desjardins, Pierre
  • Shepherd, Lois
  • Meyer, Ralph M
  • Le, Al
  • Chen, Bingshu E
  • Mittmann
subjects:
  • Hospital Costs
  • Antineoplastic Combined Chemotherapy Protocols -- Economics
  • Lymphoma -- Drug Therapy
ispartof: Journal of the National Cancer Institute, July 2015, Vol.107(7)
description: The NCIC CTG LY.12 study showed that gemcitabine, dexamethasone, and cisplatin (GDP) were noninferior to dexamethasone, cytarabine, and cisplatin (DHAP) in patients with relapsed or refractory aggressive histology lymphoma prior to autologous stem cell transplantation. We conducted an economic evaluation from the perspective of the Canadian public healthcare system based on trial data. The primary outcome was an incremental cost utility analysis comparing costs and benefits associated with GDP vs DHAP. Resource utilization data were collected from 519 Canadian patients in the trial. Costs were presented in 2012 Canadian dollars and disaggregated to highlight the major cost drivers of care. Benefit was measured as quality-adjusted life-years (QALYs) based on utilities translated from prospectively collected quality-of-life data. All statistical tests were two-sided. The mean overall costs of treatment per patient in the GDP and DHAP arms were $19 961 (95% confidence interval (CI) = $17 286 to $24 565) and $34 425 (95% CI = $31 901 to $39 520), respectively, with an incremental difference in direct medical costs of $14 464 per patient in favor of GDP (P < .001). The predominant cost driver for both treatment arms was related to hospitalizations. The mean discounted quality-adjusted overall survival with GDP was 0.161 QALYs and 0.152 QALYs for DHAP (difference = 0.01 QALYs, P = .146). In probabilistic sensitivity analysis, GDP was associated with both cost savings and improved quality-adjusted outcomes compared with DHAP in 92.6% of cost-pair simulations. GDP was associated with both lower costs and similar quality-adjusted outcomes compared with DHAP in patients with relapsed or refractory lymphoma. Considering both costs and outcomes, GDP was the dominant therapy.
language: eng
source:
identifier: E-ISSN: 1460-2105 ; PMID: 25868579 Version:1 ; DOI: 10.1093/jnci/djv106
fulltext: fulltext
issn:
  • 14602105
  • 1460-2105
url: Link


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titleGemcitabine/dexamethasone/cisplatin vs cytarabine/dexamethasone/cisplatin for relapsed or refractory aggressive-histology lymphoma: cost-utility analysis of NCIC CTG LY.12
creatorCheung, Matthew C ; Hay, Annette E ; Crump, Michael ; Imrie, Kevin R ; Song, Yuyao ; Hassan, Shazia ; Risebrough, Nancy ; Sussman, Jonathan ; Couban, Stephen ; Macdonald, David ; Kukreti, Vishal ; Kouroukis, C Tom ; Baetz, Tara ; Szwajcer, David ; Desjardins, Pierre ; Shepherd, Lois ; Meyer, Ralph M ; Le, Al ; Chen, Bingshu E ; Mittmann
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subjectHospital Costs ; Antineoplastic Combined Chemotherapy Protocols -- Economics ; Lymphoma -- Drug Therapy
descriptionThe NCIC CTG LY.12 study showed that gemcitabine, dexamethasone, and cisplatin (GDP) were noninferior to dexamethasone, cytarabine, and cisplatin (DHAP) in patients with relapsed or refractory aggressive histology lymphoma prior to autologous stem cell transplantation. We conducted an economic evaluation from the perspective of the Canadian public healthcare system based on trial data. The primary outcome was an incremental cost utility analysis comparing costs and benefits associated with GDP vs DHAP. Resource utilization data were collected from 519 Canadian patients in the trial. Costs were presented in 2012 Canadian dollars and disaggregated to highlight the major cost drivers of care. Benefit was measured as quality-adjusted life-years (QALYs) based on utilities translated from prospectively collected quality-of-life data. All statistical tests were two-sided. The mean overall costs of treatment per patient in the GDP and DHAP arms were $19 961 (95% confidence interval (CI) = $17 286 to $24 565) and $34 425 (95% CI = $31 901 to $39 520), respectively, with an incremental difference in direct medical costs of $14 464 per patient in favor of GDP (P < .001). The predominant cost driver for both treatment arms was related to hospitalizations. The mean discounted quality-adjusted overall survival with GDP was 0.161 QALYs and 0.152 QALYs for DHAP (difference = 0.01 QALYs, P = .146). In probabilistic sensitivity analysis, GDP was associated with both cost savings and improved quality-adjusted outcomes compared with DHAP in 92.6% of cost-pair simulations. GDP was associated with both lower costs and similar quality-adjusted outcomes compared with DHAP in patients with relapsed or refractory lymphoma. Considering both costs and outcomes, GDP was the dominant therapy.
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titleGemcitabine/dexamethasone/cisplatin vs cytarabine/dexamethasone/cisplatin for relapsed or refractory aggressive-histology lymphoma: cost-utility analysis of NCIC CTG LY.12
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0The NCIC CTG LY.12 study showed that gemcitabine, dexamethasone, and cisplatin (GDP) were noninferior to dexamethasone, cytarabine, and cisplatin (DHAP) in patients with relapsed or refractory aggressive histology lymphoma prior to autologous stem cell transplantation. We conducted an economic evaluation from the perspective of the Canadian public healthcare system based on trial data.
1The primary outcome was an incremental cost utility analysis comparing costs and benefits associated with GDP vs DHAP. Resource utilization data were collected from 519 Canadian patients in the trial. Costs were presented in 2012 Canadian dollars and disaggregated to highlight the major cost drivers of care. Benefit was measured as quality-adjusted life-years (QALYs) based on utilities translated from prospectively collected quality-of-life data. All statistical tests were two-sided.
2The mean overall costs of treatment per patient in the GDP and DHAP arms were $19 961 (95% confidence interval (CI) = $17 286 to $24 565) and $34 425 (95% CI = $31 901 to $39 520), respectively, with an incremental difference in direct medical costs of $14 464 per patient in favor of GDP (P < .001). The predominant cost driver for both treatment arms was related to hospitalizations. The mean discounted quality-adjusted overall survival with GDP was 0.161 QALYs and 0.152 QALYs for DHAP (difference = 0.01 QALYs, P = .146). In probabilistic sensitivity analysis, GDP was associated with both cost savings and improved quality-adjusted outcomes compared with DHAP in 92.6% of cost-pair simulations.
3GDP was associated with both lower costs and similar quality-adjusted outcomes compared with DHAP in patients with relapsed or refractory lymphoma. Considering both costs and outcomes, GDP was the dominant therapy.
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authorCheung, Matthew C ; Hay, Annette E ; Crump, Michael ; Imrie, Kevin R ; Song, Yuyao ; Hassan, Shazia ; Risebrough, Nancy ; Sussman, Jonathan ; Couban, Stephen ; Macdonald, David ; Kukreti, Vishal ; Kouroukis, C Tom ; Baetz, Tara ; Szwajcer, David ; Desjardins, Pierre ; Shepherd, Lois ; Meyer, Ralph M ; Le, Al ; Chen, Bingshu E ; Mittmann
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abstractThe NCIC CTG LY.12 study showed that gemcitabine, dexamethasone, and cisplatin (GDP) were noninferior to dexamethasone, cytarabine, and cisplatin (DHAP) in patients with relapsed or refractory aggressive histology lymphoma prior to autologous stem cell transplantation. We conducted an economic evaluation from the perspective of the Canadian public healthcare system based on trial data.
doi10.1093/jnci/djv106
pmid25868579
date2015-07