Systematic Literature Review of Economic Evaluations of Treatment Alternatives in Chronic Lymphocytic Leukemia,BioDrugs

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Systematic Literature Review of Economic Evaluations of Treatment Alternatives in Chronic Lymphocytic Leukemia
BioDrugs ( IF 5.4 ) Pub Date : 2023-02-16 , DOI: 10.1007/s40259-023-00583-9
László Lorenzovici _{1,

2} , László Szilberhorn ₃ , Szabolcs Farkas-Ráduly ₁ , Andrea Ildiko Gasparik ₂ , Andreea Mihaela Precup ₁ , Adél Gyöngyvér Nagy ₁ , Carsten Utoft Niemann _{4,

5} , Tero Aittokallio _{6,

7,

8} , Zoltán Kaló _{3,

9} , Marcell Csanádi ₃

Affiliation

Background

Economic evaluations are widely used to predict the economic impact of new treatment alternatives. Comprehensive economic reviews in the field of chronic lymphocytic leukemia (CLL) are warranted to supplement the existing analyses focused on specific therapeutic areas.

Methods

A systematic literature review was conducted based on literature searches in Medline and EMBASE to summarize the published health economics models related to all types of CLL therapies. Narrative synthesis of relevant studies was performed focusing on compared treatments, patient populations, modelling approaches and key findings.

Results

We included 29 studies, the majority of which were published between 2016 and 2018, when data from large clinical trials in CLL became available. Treatment regimens were compared in 25 cases, while the remaining four studies considered treatment strategies with more complex patient pathways. Based on the review results, Markov modelling with a simple structure of three health states (progression-free, progressed, death) can be considered as the traditional basis to simulate cost effectiveness. However, more recent studies added further complexity, including additional health states for different therapies (e.g. best supportive care or stem cell transplantation), for progression-free state (e.g. by differentiating between with or without treatment), or for response status (i.e. partial response and complete response).

Conclusions

As personalized medicine is increasingly gaining recognition, we expect that future economic evaluations will also incorporate new solutions, which are necessary to capture a larger number of genetic and molecular markers and more complex patient pathways with individual patient-level allocation of treatment options and thus economic assessments.

中文翻译：

慢性淋巴细胞白血病治疗方案经济评价的系统文献综述

背景

经济评估被广泛用于预测新治疗方案的经济影响。慢性淋巴细胞白血病 (CLL) 领域的综合经济评论有必要补充针对特定治疗领域的现有分析。

方法

基于 Medline 和 EMBASE 中的文献检索进行了系统的文献综述，以总结已发表的与所有类型的 CLL 疗法相关的健康经济学模型。对相关研究进行了叙述性综合，重点是比较治疗、患者人群、建模方法和主要发现。

结果

我们纳入了 29 项研究，其中大部分发表于 2016 年至 2018 年期间，当时可获得 CLL 大型临床试验的数据。在 25 个案例中比较了治疗方案，而其余四项研究考虑了具有更复杂患者路径的治疗策略。根据审查结果，具有三种健康状态（无进展、进展、死亡）的简单结构的马尔可夫模型可以被视为模拟成本效益的传统基础。然而，最近的研究进一步增加了复杂性，包括不同疗法（例如最佳支持治疗或干细胞移植）的额外健康状态、无进展状态（例如通过区分有或没有治疗）或反应状态（即部分响应和完整响应）。