Genomic testing for CLL treatment not cost effective in UK

Genomic testing for CLL treatment not cost effective in UK PharmacoEconomics & Outcomes News 784, p17 - 12 Aug 2017 Genomic testing for CLL treatment not cost effective in UK The use of genomic testing to stratify patients and provide targeted treatment for chronic lymphocytic leukaemia (CLL) is not cost effective from a UK NHS perspective, according to an article in PharmacoEconomics. The authors utilised a decision-analytic model to evaluate the cost effectiveness and cost utility of genomic testing to target treatment decisions in adults with CLL in the UK. Five current and future practice strategies were evaluated which included genetic testing, no testing and genomic testing, with or without the use of ibrutinib in patients refractory to first-line treatment. Costs were reported in 2013 values with a 3.5% discount applied, and were assessed from both a UK NHS perspective and a societal perspective. Societal costs included productivity, informal care and out-of- pocket costs. Using a cost-effectiveness threshold of £30 000 per life-year or quality-adjusted-life-year (QALY) gained, the most cost-effective strategy was current genetic testing practice to stratify patients by likely response to first-line treatment without the use of ibrutinib for refractory patients. Although the future genomic testing strategies were associated with the most life-years and QALYs per patient, these strategies were not deemed cost effective when the cost-effectiveness threshold was applied. However, scenario analyses indicated that future genomic testing strategies would become cost effective if a higher threshold of £50 000 was applied, the cost of ibrutinib treatment fell or if further consideration was given to the societal costs associated with younger patients. The cost of ibrutinib treatment was noted as being the key driving factor for the cost effectiveness of the genomic testing strategies. The authors concluded that the results "suggest that stratifying patients with CLL to targeted treatment using genomic testing is not a cost-effective use of limited NHS resources, primarily owing to the high cost of ibrutinib treatment". Buchanan J, et al. Using Genomic Information to Guide Ibrutinib Treatment Decisions in Chronic Lymphocytic Leukaemia: A Cost-Effectiveness Analysis. PharmacoEconomics : 31 Jul 2017. Available from: URL: http:// dx.doi.org/10.1007/s40273-017-0519-z 803262856 1173-5503/17/0784-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 12 Aug 2017 No. 784 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png PharmacoEconomics & Outcomes News Springer Journals

Genomic testing for CLL treatment not cost effective in UK

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Publisher
Springer International Publishing
Copyright
Copyright © 2017 by Springer International Publishing AG
Subject
Medicine & Public Health; Pharmacoeconomics and Health Outcomes; Quality of Life Research; Health Economics; Public Health
ISSN
1173-5503
eISSN
1179-2043
D.O.I.
10.1007/s40274-017-4228-9
Publisher site
See Article on Publisher Site

Abstract

PharmacoEconomics & Outcomes News 784, p17 - 12 Aug 2017 Genomic testing for CLL treatment not cost effective in UK The use of genomic testing to stratify patients and provide targeted treatment for chronic lymphocytic leukaemia (CLL) is not cost effective from a UK NHS perspective, according to an article in PharmacoEconomics. The authors utilised a decision-analytic model to evaluate the cost effectiveness and cost utility of genomic testing to target treatment decisions in adults with CLL in the UK. Five current and future practice strategies were evaluated which included genetic testing, no testing and genomic testing, with or without the use of ibrutinib in patients refractory to first-line treatment. Costs were reported in 2013 values with a 3.5% discount applied, and were assessed from both a UK NHS perspective and a societal perspective. Societal costs included productivity, informal care and out-of- pocket costs. Using a cost-effectiveness threshold of £30 000 per life-year or quality-adjusted-life-year (QALY) gained, the most cost-effective strategy was current genetic testing practice to stratify patients by likely response to first-line treatment without the use of ibrutinib for refractory patients. Although the future genomic testing strategies were associated with the most life-years and QALYs per patient, these strategies were not deemed cost effective when the cost-effectiveness threshold was applied. However, scenario analyses indicated that future genomic testing strategies would become cost effective if a higher threshold of £50 000 was applied, the cost of ibrutinib treatment fell or if further consideration was given to the societal costs associated with younger patients. The cost of ibrutinib treatment was noted as being the key driving factor for the cost effectiveness of the genomic testing strategies. The authors concluded that the results "suggest that stratifying patients with CLL to targeted treatment using genomic testing is not a cost-effective use of limited NHS resources, primarily owing to the high cost of ibrutinib treatment". Buchanan J, et al. Using Genomic Information to Guide Ibrutinib Treatment Decisions in Chronic Lymphocytic Leukaemia: A Cost-Effectiveness Analysis. PharmacoEconomics : 31 Jul 2017. Available from: URL: http:// dx.doi.org/10.1007/s40273-017-0519-z 803262856 1173-5503/17/0784-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 12 Aug 2017 No. 784

Journal

PharmacoEconomics & Outcomes NewsSpringer Journals

Published: Aug 12, 2017

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