Cost Effectiveness
Cost-effectiveness analysis is an increasingly important tool for healthcare decision-making in the context of increasing budgetary constraints, an ever-increasing range of treatment options, and the relatively high price of new treatments.1-3
THERAKOS ECP ImmunomodulationTM has been shown to be a cost-effective treatment for acute and chronic graft-versus-host disease, cutaneous T-cell lymphoma (CTCL), and chronic lung allograft dysfunction-bronchiolitis obliterans syndrome (CLAD-BOS).3-8
In addition, studies show that THERAKOS ECP ImmunomodulationTM may help to minimise the costs associated with immunosuppressing the patient.3,4
Cost Effectiveness in Acute GVHD
In acute GVHD, THERAKOS ECP ImmunomodulationTM has shown cost-effectiveness in adults7
Wepsięć 2012 (Poland)1
*Subgroup analysis not representative of the entire study population.
†The CE threshold is calculated as a value of GDP per capita, between 2007–2009, GDP was estimated at 33,181 PLN, a cost-effective therapy is 2 x GDP, a highly cost-effective therapy is 1 x GDP.
AE, adverse event; CE, cost-effectiveness; CER, cost-effectiveness ratio; ECP, extracorporeal photopheresis; GDP, gross domestic product; GvHD, graft-versus-host disease; HSCT, haematopoietic stem cell transplantation; LY, life-year; PLN, Polish zloty (currency of Poland); QoL, quality of life.
1. Wepsięć K, et al. Cost-effectiveness analysis of extracorporeal photopheresis (procedure TherakosTM) in the treatment of steroid-refractory graft versus host disease. Kraków (Poland): Instytut Arcana; 2012. 80 p.
Cost Effectiveness in Chronic GVHD
In chronic GVHD, THERAKOS ECP ImmunomodulationTM has shown cost-effectiveness in adults3,5,7
De Waure 2015 (Italy)1
*Sub group analysis not representative of the entire study population.
†Compared with alternatives, a treatment or intervention is dominant when it is both more effective and less costly.
AE, adverse event; CE, cost-effectiveness; ECP, extracorporeal photopheresis; GvHD, graft-versus-host disease; HSCT, haematopoietic stem cell transplantation; ICUR, incremental cost-utility ratio; NHS, National Health Service; QALY, quality-adjusted life year; QoL, quality of life.
1. de Waure C, et al. Value Health. 2015;18(4):457-466.
Wepsięć 2012 (Poland)1
*Subgroup analysis not representative of the entire study population.
†The CE threshold is calculated as a value of GDP per capita, between 2007–2009, GDP was estimated at 33,181 PLN, a cost-effective therapy is 2 x GDP, a highly cost-effective therapy is 1 x GDP.
AE, adverse event; CE, cost-effectiveness; CER, cost-effectiveness ratio; ECP, extracorporeal photopheresis; GDP, gross domestic product; GvHD, graft-versus-host disease; HSCT, haematopoietic stem cell transplantation; LY, life-year; PLN, Polish zloty (currency of Poland); QoL, quality of life.
1. Wepsięć K, et al. Cost-effectiveness analysis of extracorporeal photopheresis (procedure Therakos™) in the treatment of steroid-refractory graft versus host disease. Kraków (Poland): Instytut Arcana; 2012. 80 p.
Crespo 2012 (Spain)1
*Subgroup analysis not representative of the entire study population.
†The CE threshold is an ICUR threshold below which an intervention is deemed cost-effective.
CE, cost-effectiveness; ECP, extracorporeal photopheresis; GvHD, graft-versus-host disease; HSCT, haematopoietic stem cell transplantation; ICER, incremental cost-effectiveness ratio; ICUR, incremental cost-utility ratio; QALY, quality-adjusted life year.
1. Crespo C, et al. Clin Ther. 2012;34(8):1774-1787.
Cost Effectiveness in CTCL
In CTCL, THERAKOS ECP ImmunomodulationTM has shown cost-effectiveness in adults6
Geskin 2018 (United States)1
*Device used and treatment regimen were not specified within the model used.
†Cost-effectiveness threshold was not provided in the report, costs were compared to the lowest-cost-treatment methotrexate
AE, adverse event; CTCL, cutaneous T-cell lymphoma; ECP, extracorporeal photopheresis; ICER, incremental cost-effectiveness ratio.
1. Reskin L, Malone DC. J Dermatolog Treat. 2018;29(5):522-530.
Cost Effectiveness in CLAD-BOS
In CLAD-BOS, THERAKOS ECP ImmunomodulationTM has shown cost-effectiveness in adults8
ECP has been shown to be cost-effective compared to other pharmacological therapies for the treatment of BOS1
AE, adverse event; BOS, bronchiolitis obliterans syndrome; CLAD, chronic lung allograft dysfunction; ECP, extracorporeal photopheresis; GI, gastrointestinal.
1. Zia A, et al. Value Health PRS14. 2019;22(2):S351. 2. Jaksch P, et al. J Heart Lung Transpl. 2012;38(4S). 3. Benden C, et al. J Heart Lung Transpl. 2017;36:921-933.
Jaksch 2012 (United States)1
*Triple-drug regimen of calcineurin inhibitor, mycophenolate mofetil and prednisolone plus proton pump inhibitors as per routine practice. Patients diagnosed with BOS and on cyclosporine-based immunosuppressive regimen were switched to tacrolimus, had their immunosuppressive dose increased, and were administered a high-dose methylprednisolone pulse (10–15 mg/kg body weight).
†Only patients who had a follow-up of 3 months minimum were included in data analysis.
‡Non-responders were defined as patients who had a reduction if FEV1 of more than 5% from baseline at start of ECP after 3, 6, or 12 months.
AE, adverse event; BOS, bronchiolitis obliterans syndrome; CF, cystic fibrosis; CMV, cytomegalovirus; ECP, extracorporeal photopheresis; FEV1, forced expiratory volume in 1 second.
1. Jaksch P, et al. J Heart Lung Transpl. 2012;38(4S).
BOS, bronchiolitis obliterans syndrome; CLAD, chronic lung allograft dysfunction; ECP, extracorporeal photopheresis; CTCL, cutaneous T-cell lymphoma; GvHD, graft-versus-host disease.
References:
1. Hill SR. BMC Med. 2012;10:10; 2. Eichler HG, et al. Value Health. 2004;7(5):518-528; 3. Crespo C, et al. Clin Ther. 2012;34(8):1774-1787; 4. Walczak J, et al. Value Health. 2012;15:A349; 5. de Waure C, et al. Value Health. 2015;18(4):457-466; 6. Geskin L, Malone DC. J Dermatolog Treat. 2018;29(5):522-530. 7. Wepsięć K, et al. Cost-effectiveness analysis of extracorporeal photopheresis (procedure TherakosTM) in the treatment of steroid-refractory graft versus host disease. Kraków (Poland): Instytut Arcana; 2012. 80 p. 8. Zia A, et al. Value Health PRS14. 2019;22(2):S351. 9. Jaksch P, et al. J Heart Lung Transpl. 2012;38(4S). 10. Benden C, et al. J Heart Lung Transpl. 2017;36:921-933.
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