Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective

Xiao Jun Wang,1 Yi-Ho Wang,2 Matthew Jian Chun Ong,1 Christina Gkitzia,3 Shui Yen Soh,4 William Ying Khee Hwang5– 7 1Novartis Singapore Pte Ltd, Singapore; 2Novartis Asia Pacific Pharmaceuticals Pte Ltd, Singapore; 3Novartis Pharma AG, Basel, Switzerland; 4KK Women’s & Children’s Hospital, Singapore; 5National Cancer Centre Singapore, Singapore; 6Singapore General Hospital, Singapore; 7Duke-NUS Medical School, SingaporeCorrespondence: Xiao Jun Wang, Novartis Singapore Pte Ltd, 20 Pasir Panjang Road, #10-25/28 Mapletree Business City (West Tower), 117439, Singapore, Tel +65 67226010, Email nick-1.wangnovartis.comPurpose: Children and young adults with relapsed or refractory (r/r) acute lymphoblastic leukemia (ALL) have poor survival due to ineffective therapy options. The newly approved chimeric antigen receptor T-cell (CAR-T) therapy, tisagenlecleucel, has demonstrated improved survival but at a high up-front cost. The study aims to evaluate the cost-effectiveness and budget impact of tisagenlecleucel versus salvage chemotherapy regimen (SCR) or blinatumomab (BLN) for the treatment of pediatric and young adult patients with relapsed/refractory B-cell ALL from the Singapore healthcare system perspective.Patients and Methods: A three-health state partitioned survival model was constructed to analyze the cost-effectiveness of tisagenlecleucel vs SCR/BLN with/without allogenic hematopoietic stem cell transplantation (allo-HSCT) over a lifetime period. Clinical efficacy for tisagenlecleucel, SCR and BLN were based on pooled data from ELIANA, ENSIGN and B2101J trials, the study by von Stackelberg et al 2011, and MT103-205 respectively. Medical costs from pre-treatment until terminal care, including treatment, side effects, follow-up, subsequent allo-HSCT and relapse, were considered. Incremental cost-effectiveness ratios (ICERs) were estimated as the incremental costs per quality-adjusted life-year (QALY) gain. Additionally, the financial impact of tisagenlecleucel introduction in Singapore was estimated, comparing the present treatment scenario (without tisagenlecleucel) with a future scenario (with tisagenlecleucel), over 5 years.Results: In the base-case analysis, tisagenlecleucel treatment demonstrated cost-effectiveness with an ICER of S$45,840 (US$34,762) per QALY (vs SCR) and S$51,978 (US$39,315) per QALY (vs BLN). The estimated budget ranges from S$477,857 (US$361,438) to S$1.4 million (US$1.05 million) annually for the initial 5 years.Conclusion: Tisagenlecleucel is likely to be a cost-effective treatment option with limited budget implications while treating r/r ALL patients who have failed at least 2 lines of prior therapies.Keywords: tisagenlecleucel, acute lymphocytic leukemia, partition survival model, cost-effectiveness, budget impact, Singapore Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Wang XJ [verfasserIn] Wang YH [verfasserIn] Ong MJC [verfasserIn] Gkitzia C [verfasserIn] Soh SY [verfasserIn] Hwang WYK [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	tisagenlecleucel acute lymphocytic leukemia partition survival model cost-effectiveness budget impact singapore

Übergeordnetes Werk:	In: ClinicoEconomics and Outcomes Research - Dove Medical Press, 2010, (2022), Seite 333-355
Übergeordnetes Werk:	year:2022 ; pages:333-355

Links:	Link aufrufen Link aufrufen Journal toc

Katalog-ID:	DOAJ022116508

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allfields	(DE-627)DOAJ022116508 (DE-599)DOAJ80d37a3c65b74bbb8a62a00fb75a86d1 DE-627 ger DE-627 rakwb eng R5-920 RM1-950 Wang XJ verfasserin aut Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Xiao Jun Wang,1 Yi-Ho Wang,2 Matthew Jian Chun Ong,1 Christina Gkitzia,3 Shui Yen Soh,4 William Ying Khee Hwang5– 7 1Novartis Singapore Pte Ltd, Singapore; 2Novartis Asia Pacific Pharmaceuticals Pte Ltd, Singapore; 3Novartis Pharma AG, Basel, Switzerland; 4KK Women’s & Children’s Hospital, Singapore; 5National Cancer Centre Singapore, Singapore; 6Singapore General Hospital, Singapore; 7Duke-NUS Medical School, SingaporeCorrespondence: Xiao Jun Wang, Novartis Singapore Pte Ltd, 20 Pasir Panjang Road, #10-25/28 Mapletree Business City (West Tower), 117439, Singapore, Tel +65 67226010, Email nick-1.wangnovartis.comPurpose: Children and young adults with relapsed or refractory (r/r) acute lymphoblastic leukemia (ALL) have poor survival due to ineffective therapy options. The newly approved chimeric antigen receptor T-cell (CAR-T) therapy, tisagenlecleucel, has demonstrated improved survival but at a high up-front cost. The study aims to evaluate the cost-effectiveness and budget impact of tisagenlecleucel versus salvage chemotherapy regimen (SCR) or blinatumomab (BLN) for the treatment of pediatric and young adult patients with relapsed/refractory B-cell ALL from the Singapore healthcare system perspective.Patients and Methods: A three-health state partitioned survival model was constructed to analyze the cost-effectiveness of tisagenlecleucel vs SCR/BLN with/without allogenic hematopoietic stem cell transplantation (allo-HSCT) over a lifetime period. Clinical efficacy for tisagenlecleucel, SCR and BLN were based on pooled data from ELIANA, ENSIGN and B2101J trials, the study by von Stackelberg et al 2011, and MT103-205 respectively. Medical costs from pre-treatment until terminal care, including treatment, side effects, follow-up, subsequent allo-HSCT and relapse, were considered. Incremental cost-effectiveness ratios (ICERs) were estimated as the incremental costs per quality-adjusted life-year (QALY) gain. Additionally, the financial impact of tisagenlecleucel introduction in Singapore was estimated, comparing the present treatment scenario (without tisagenlecleucel) with a future scenario (with tisagenlecleucel), over 5 years.Results: In the base-case analysis, tisagenlecleucel treatment demonstrated cost-effectiveness with an ICER of S$45,840 (US$34,762) per QALY (vs SCR) and S$51,978 (US$39,315) per QALY (vs BLN). The estimated budget ranges from S$477,857 (US$361,438) to S$1.4 million (US$1.05 million) annually for the initial 5 years.Conclusion: Tisagenlecleucel is likely to be a cost-effective treatment option with limited budget implications while treating r/r ALL patients who have failed at least 2 lines of prior therapies.Keywords: tisagenlecleucel, acute lymphocytic leukemia, partition survival model, cost-effectiveness, budget impact, Singapore tisagenlecleucel acute lymphocytic leukemia partition survival model cost-effectiveness budget impact singapore Medicine (General) Therapeutics. Pharmacology Wang YH verfasserin aut Ong MJC verfasserin aut Gkitzia C verfasserin aut Soh SY verfasserin aut Hwang WYK verfasserin aut In ClinicoEconomics and Outcomes Research Dove Medical Press, 2010 (2022), Seite 333-355 (DE-627)611725843 (DE-600)2520698-9 11786981 nnns year:2022 pages:333-355 https://doaj.org/article/80d37a3c65b74bbb8a62a00fb75a86d1 kostenfrei https://www.dovepress.com/cost-effectiveness-and-budget-impact-analyses-of-tisagenlecleucel-in-p-peer-reviewed-fulltext-article-CEOR kostenfrei https://doaj.org/toc/1178-6981 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2022 333-355
spelling	(DE-627)DOAJ022116508 (DE-599)DOAJ80d37a3c65b74bbb8a62a00fb75a86d1 DE-627 ger DE-627 rakwb eng R5-920 RM1-950 Wang XJ verfasserin aut Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Xiao Jun Wang,1 Yi-Ho Wang,2 Matthew Jian Chun Ong,1 Christina Gkitzia,3 Shui Yen Soh,4 William Ying Khee Hwang5– 7 1Novartis Singapore Pte Ltd, Singapore; 2Novartis Asia Pacific Pharmaceuticals Pte Ltd, Singapore; 3Novartis Pharma AG, Basel, Switzerland; 4KK Women’s & Children’s Hospital, Singapore; 5National Cancer Centre Singapore, Singapore; 6Singapore General Hospital, Singapore; 7Duke-NUS Medical School, SingaporeCorrespondence: Xiao Jun Wang, Novartis Singapore Pte Ltd, 20 Pasir Panjang Road, #10-25/28 Mapletree Business City (West Tower), 117439, Singapore, Tel +65 67226010, Email nick-1.wangnovartis.comPurpose: Children and young adults with relapsed or refractory (r/r) acute lymphoblastic leukemia (ALL) have poor survival due to ineffective therapy options. The newly approved chimeric antigen receptor T-cell (CAR-T) therapy, tisagenlecleucel, has demonstrated improved survival but at a high up-front cost. The study aims to evaluate the cost-effectiveness and budget impact of tisagenlecleucel versus salvage chemotherapy regimen (SCR) or blinatumomab (BLN) for the treatment of pediatric and young adult patients with relapsed/refractory B-cell ALL from the Singapore healthcare system perspective.Patients and Methods: A three-health state partitioned survival model was constructed to analyze the cost-effectiveness of tisagenlecleucel vs SCR/BLN with/without allogenic hematopoietic stem cell transplantation (allo-HSCT) over a lifetime period. Clinical efficacy for tisagenlecleucel, SCR and BLN were based on pooled data from ELIANA, ENSIGN and B2101J trials, the study by von Stackelberg et al 2011, and MT103-205 respectively. Medical costs from pre-treatment until terminal care, including treatment, side effects, follow-up, subsequent allo-HSCT and relapse, were considered. Incremental cost-effectiveness ratios (ICERs) were estimated as the incremental costs per quality-adjusted life-year (QALY) gain. Additionally, the financial impact of tisagenlecleucel introduction in Singapore was estimated, comparing the present treatment scenario (without tisagenlecleucel) with a future scenario (with tisagenlecleucel), over 5 years.Results: In the base-case analysis, tisagenlecleucel treatment demonstrated cost-effectiveness with an ICER of S$45,840 (US$34,762) per QALY (vs SCR) and S$51,978 (US$39,315) per QALY (vs BLN). The estimated budget ranges from S$477,857 (US$361,438) to S$1.4 million (US$1.05 million) annually for the initial 5 years.Conclusion: Tisagenlecleucel is likely to be a cost-effective treatment option with limited budget implications while treating r/r ALL patients who have failed at least 2 lines of prior therapies.Keywords: tisagenlecleucel, acute lymphocytic leukemia, partition survival model, cost-effectiveness, budget impact, Singapore tisagenlecleucel acute lymphocytic leukemia partition survival model cost-effectiveness budget impact singapore Medicine (General) Therapeutics. Pharmacology Wang YH verfasserin aut Ong MJC verfasserin aut Gkitzia C verfasserin aut Soh SY verfasserin aut Hwang WYK verfasserin aut In ClinicoEconomics and Outcomes Research Dove Medical Press, 2010 (2022), Seite 333-355 (DE-627)611725843 (DE-600)2520698-9 11786981 nnns year:2022 pages:333-355 https://doaj.org/article/80d37a3c65b74bbb8a62a00fb75a86d1 kostenfrei https://www.dovepress.com/cost-effectiveness-and-budget-impact-analyses-of-tisagenlecleucel-in-p-peer-reviewed-fulltext-article-CEOR kostenfrei https://doaj.org/toc/1178-6981 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2022 333-355
allfields_unstemmed	(DE-627)DOAJ022116508 (DE-599)DOAJ80d37a3c65b74bbb8a62a00fb75a86d1 DE-627 ger DE-627 rakwb eng R5-920 RM1-950 Wang XJ verfasserin aut Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Xiao Jun Wang,1 Yi-Ho Wang,2 Matthew Jian Chun Ong,1 Christina Gkitzia,3 Shui Yen Soh,4 William Ying Khee Hwang5– 7 1Novartis Singapore Pte Ltd, Singapore; 2Novartis Asia Pacific Pharmaceuticals Pte Ltd, Singapore; 3Novartis Pharma AG, Basel, Switzerland; 4KK Women’s & Children’s Hospital, Singapore; 5National Cancer Centre Singapore, Singapore; 6Singapore General Hospital, Singapore; 7Duke-NUS Medical School, SingaporeCorrespondence: Xiao Jun Wang, Novartis Singapore Pte Ltd, 20 Pasir Panjang Road, #10-25/28 Mapletree Business City (West Tower), 117439, Singapore, Tel +65 67226010, Email nick-1.wangnovartis.comPurpose: Children and young adults with relapsed or refractory (r/r) acute lymphoblastic leukemia (ALL) have poor survival due to ineffective therapy options. The newly approved chimeric antigen receptor T-cell (CAR-T) therapy, tisagenlecleucel, has demonstrated improved survival but at a high up-front cost. The study aims to evaluate the cost-effectiveness and budget impact of tisagenlecleucel versus salvage chemotherapy regimen (SCR) or blinatumomab (BLN) for the treatment of pediatric and young adult patients with relapsed/refractory B-cell ALL from the Singapore healthcare system perspective.Patients and Methods: A three-health state partitioned survival model was constructed to analyze the cost-effectiveness of tisagenlecleucel vs SCR/BLN with/without allogenic hematopoietic stem cell transplantation (allo-HSCT) over a lifetime period. Clinical efficacy for tisagenlecleucel, SCR and BLN were based on pooled data from ELIANA, ENSIGN and B2101J trials, the study by von Stackelberg et al 2011, and MT103-205 respectively. Medical costs from pre-treatment until terminal care, including treatment, side effects, follow-up, subsequent allo-HSCT and relapse, were considered. Incremental cost-effectiveness ratios (ICERs) were estimated as the incremental costs per quality-adjusted life-year (QALY) gain. Additionally, the financial impact of tisagenlecleucel introduction in Singapore was estimated, comparing the present treatment scenario (without tisagenlecleucel) with a future scenario (with tisagenlecleucel), over 5 years.Results: In the base-case analysis, tisagenlecleucel treatment demonstrated cost-effectiveness with an ICER of S$45,840 (US$34,762) per QALY (vs SCR) and S$51,978 (US$39,315) per QALY (vs BLN). The estimated budget ranges from S$477,857 (US$361,438) to S$1.4 million (US$1.05 million) annually for the initial 5 years.Conclusion: Tisagenlecleucel is likely to be a cost-effective treatment option with limited budget implications while treating r/r ALL patients who have failed at least 2 lines of prior therapies.Keywords: tisagenlecleucel, acute lymphocytic leukemia, partition survival model, cost-effectiveness, budget impact, Singapore tisagenlecleucel acute lymphocytic leukemia partition survival model cost-effectiveness budget impact singapore Medicine (General) Therapeutics. Pharmacology Wang YH verfasserin aut Ong MJC verfasserin aut Gkitzia C verfasserin aut Soh SY verfasserin aut Hwang WYK verfasserin aut In ClinicoEconomics and Outcomes Research Dove Medical Press, 2010 (2022), Seite 333-355 (DE-627)611725843 (DE-600)2520698-9 11786981 nnns year:2022 pages:333-355 https://doaj.org/article/80d37a3c65b74bbb8a62a00fb75a86d1 kostenfrei https://www.dovepress.com/cost-effectiveness-and-budget-impact-analyses-of-tisagenlecleucel-in-p-peer-reviewed-fulltext-article-CEOR kostenfrei https://doaj.org/toc/1178-6981 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2022 333-355
allfieldsGer	(DE-627)DOAJ022116508 (DE-599)DOAJ80d37a3c65b74bbb8a62a00fb75a86d1 DE-627 ger DE-627 rakwb eng R5-920 RM1-950 Wang XJ verfasserin aut Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Xiao Jun Wang,1 Yi-Ho Wang,2 Matthew Jian Chun Ong,1 Christina Gkitzia,3 Shui Yen Soh,4 William Ying Khee Hwang5– 7 1Novartis Singapore Pte Ltd, Singapore; 2Novartis Asia Pacific Pharmaceuticals Pte Ltd, Singapore; 3Novartis Pharma AG, Basel, Switzerland; 4KK Women’s & Children’s Hospital, Singapore; 5National Cancer Centre Singapore, Singapore; 6Singapore General Hospital, Singapore; 7Duke-NUS Medical School, SingaporeCorrespondence: Xiao Jun Wang, Novartis Singapore Pte Ltd, 20 Pasir Panjang Road, #10-25/28 Mapletree Business City (West Tower), 117439, Singapore, Tel +65 67226010, Email nick-1.wangnovartis.comPurpose: Children and young adults with relapsed or refractory (r/r) acute lymphoblastic leukemia (ALL) have poor survival due to ineffective therapy options. The newly approved chimeric antigen receptor T-cell (CAR-T) therapy, tisagenlecleucel, has demonstrated improved survival but at a high up-front cost. The study aims to evaluate the cost-effectiveness and budget impact of tisagenlecleucel versus salvage chemotherapy regimen (SCR) or blinatumomab (BLN) for the treatment of pediatric and young adult patients with relapsed/refractory B-cell ALL from the Singapore healthcare system perspective.Patients and Methods: A three-health state partitioned survival model was constructed to analyze the cost-effectiveness of tisagenlecleucel vs SCR/BLN with/without allogenic hematopoietic stem cell transplantation (allo-HSCT) over a lifetime period. Clinical efficacy for tisagenlecleucel, SCR and BLN were based on pooled data from ELIANA, ENSIGN and B2101J trials, the study by von Stackelberg et al 2011, and MT103-205 respectively. Medical costs from pre-treatment until terminal care, including treatment, side effects, follow-up, subsequent allo-HSCT and relapse, were considered. Incremental cost-effectiveness ratios (ICERs) were estimated as the incremental costs per quality-adjusted life-year (QALY) gain. Additionally, the financial impact of tisagenlecleucel introduction in Singapore was estimated, comparing the present treatment scenario (without tisagenlecleucel) with a future scenario (with tisagenlecleucel), over 5 years.Results: In the base-case analysis, tisagenlecleucel treatment demonstrated cost-effectiveness with an ICER of S$45,840 (US$34,762) per QALY (vs SCR) and S$51,978 (US$39,315) per QALY (vs BLN). The estimated budget ranges from S$477,857 (US$361,438) to S$1.4 million (US$1.05 million) annually for the initial 5 years.Conclusion: Tisagenlecleucel is likely to be a cost-effective treatment option with limited budget implications while treating r/r ALL patients who have failed at least 2 lines of prior therapies.Keywords: tisagenlecleucel, acute lymphocytic leukemia, partition survival model, cost-effectiveness, budget impact, Singapore tisagenlecleucel acute lymphocytic leukemia partition survival model cost-effectiveness budget impact singapore Medicine (General) Therapeutics. Pharmacology Wang YH verfasserin aut Ong MJC verfasserin aut Gkitzia C verfasserin aut Soh SY verfasserin aut Hwang WYK verfasserin aut In ClinicoEconomics and Outcomes Research Dove Medical Press, 2010 (2022), Seite 333-355 (DE-627)611725843 (DE-600)2520698-9 11786981 nnns year:2022 pages:333-355 https://doaj.org/article/80d37a3c65b74bbb8a62a00fb75a86d1 kostenfrei https://www.dovepress.com/cost-effectiveness-and-budget-impact-analyses-of-tisagenlecleucel-in-p-peer-reviewed-fulltext-article-CEOR kostenfrei https://doaj.org/toc/1178-6981 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2022 333-355
allfieldsSound	(DE-627)DOAJ022116508 (DE-599)DOAJ80d37a3c65b74bbb8a62a00fb75a86d1 DE-627 ger DE-627 rakwb eng R5-920 RM1-950 Wang XJ verfasserin aut Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Xiao Jun Wang,1 Yi-Ho Wang,2 Matthew Jian Chun Ong,1 Christina Gkitzia,3 Shui Yen Soh,4 William Ying Khee Hwang5– 7 1Novartis Singapore Pte Ltd, Singapore; 2Novartis Asia Pacific Pharmaceuticals Pte Ltd, Singapore; 3Novartis Pharma AG, Basel, Switzerland; 4KK Women’s & Children’s Hospital, Singapore; 5National Cancer Centre Singapore, Singapore; 6Singapore General Hospital, Singapore; 7Duke-NUS Medical School, SingaporeCorrespondence: Xiao Jun Wang, Novartis Singapore Pte Ltd, 20 Pasir Panjang Road, #10-25/28 Mapletree Business City (West Tower), 117439, Singapore, Tel +65 67226010, Email nick-1.wangnovartis.comPurpose: Children and young adults with relapsed or refractory (r/r) acute lymphoblastic leukemia (ALL) have poor survival due to ineffective therapy options. The newly approved chimeric antigen receptor T-cell (CAR-T) therapy, tisagenlecleucel, has demonstrated improved survival but at a high up-front cost. The study aims to evaluate the cost-effectiveness and budget impact of tisagenlecleucel versus salvage chemotherapy regimen (SCR) or blinatumomab (BLN) for the treatment of pediatric and young adult patients with relapsed/refractory B-cell ALL from the Singapore healthcare system perspective.Patients and Methods: A three-health state partitioned survival model was constructed to analyze the cost-effectiveness of tisagenlecleucel vs SCR/BLN with/without allogenic hematopoietic stem cell transplantation (allo-HSCT) over a lifetime period. Clinical efficacy for tisagenlecleucel, SCR and BLN were based on pooled data from ELIANA, ENSIGN and B2101J trials, the study by von Stackelberg et al 2011, and MT103-205 respectively. Medical costs from pre-treatment until terminal care, including treatment, side effects, follow-up, subsequent allo-HSCT and relapse, were considered. Incremental cost-effectiveness ratios (ICERs) were estimated as the incremental costs per quality-adjusted life-year (QALY) gain. Additionally, the financial impact of tisagenlecleucel introduction in Singapore was estimated, comparing the present treatment scenario (without tisagenlecleucel) with a future scenario (with tisagenlecleucel), over 5 years.Results: In the base-case analysis, tisagenlecleucel treatment demonstrated cost-effectiveness with an ICER of S$45,840 (US$34,762) per QALY (vs SCR) and S$51,978 (US$39,315) per QALY (vs BLN). The estimated budget ranges from S$477,857 (US$361,438) to S$1.4 million (US$1.05 million) annually for the initial 5 years.Conclusion: Tisagenlecleucel is likely to be a cost-effective treatment option with limited budget implications while treating r/r ALL patients who have failed at least 2 lines of prior therapies.Keywords: tisagenlecleucel, acute lymphocytic leukemia, partition survival model, cost-effectiveness, budget impact, Singapore tisagenlecleucel acute lymphocytic leukemia partition survival model cost-effectiveness budget impact singapore Medicine (General) Therapeutics. Pharmacology Wang YH verfasserin aut Ong MJC verfasserin aut Gkitzia C verfasserin aut Soh SY verfasserin aut Hwang WYK verfasserin aut In ClinicoEconomics and Outcomes Research Dove Medical Press, 2010 (2022), Seite 333-355 (DE-627)611725843 (DE-600)2520698-9 11786981 nnns year:2022 pages:333-355 https://doaj.org/article/80d37a3c65b74bbb8a62a00fb75a86d1 kostenfrei https://www.dovepress.com/cost-effectiveness-and-budget-impact-analyses-of-tisagenlecleucel-in-p-peer-reviewed-fulltext-article-CEOR kostenfrei https://doaj.org/toc/1178-6981 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2022 333-355
language	English
source	In ClinicoEconomics and Outcomes Research (2022), Seite 333-355 year:2022 pages:333-355
sourceStr	In ClinicoEconomics and Outcomes Research (2022), Seite 333-355 year:2022 pages:333-355
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	tisagenlecleucel acute lymphocytic leukemia partition survival model cost-effectiveness budget impact singapore Medicine (General) Therapeutics. Pharmacology
isfreeaccess_bool	true
container_title	ClinicoEconomics and Outcomes Research
authorswithroles_txt_mv	Wang XJ @@aut@@ Wang YH @@aut@@ Ong MJC @@aut@@ Gkitzia C @@aut@@ Soh SY @@aut@@ Hwang WYK @@aut@@
publishDateDaySort_date	2022-01-01T00:00:00Z
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fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ022116508</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230307053738.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230226s2022 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ022116508</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJ80d37a3c65b74bbb8a62a00fb75a86d1</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">R5-920</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RM1-950</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Wang XJ</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2022</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Xiao Jun Wang,1 Yi-Ho Wang,2 Matthew Jian Chun Ong,1 Christina Gkitzia,3 Shui Yen Soh,4 William Ying Khee Hwang5– 7 1Novartis Singapore Pte Ltd, Singapore; 2Novartis Asia Pacific Pharmaceuticals Pte Ltd, Singapore; 3Novartis Pharma AG, Basel, Switzerland; 4KK Women’s & Children’s Hospital, Singapore; 5National Cancer Centre Singapore, Singapore; 6Singapore General Hospital, Singapore; 7Duke-NUS Medical School, SingaporeCorrespondence: Xiao Jun Wang, Novartis Singapore Pte Ltd, 20 Pasir Panjang Road, #10-25/28 Mapletree Business City (West Tower), 117439, Singapore, Tel +65 67226010, Email nick-1.wangnovartis.comPurpose: Children and young adults with relapsed or refractory (r/r) acute lymphoblastic leukemia (ALL) have poor survival due to ineffective therapy options. The newly approved chimeric antigen receptor T-cell (CAR-T) therapy, tisagenlecleucel, has demonstrated improved survival but at a high up-front cost. The study aims to evaluate the cost-effectiveness and budget impact of tisagenlecleucel versus salvage chemotherapy regimen (SCR) or blinatumomab (BLN) for the treatment of pediatric and young adult patients with relapsed/refractory B-cell ALL from the Singapore healthcare system perspective.Patients and Methods: A three-health state partitioned survival model was constructed to analyze the cost-effectiveness of tisagenlecleucel vs SCR/BLN with/without allogenic hematopoietic stem cell transplantation (allo-HSCT) over a lifetime period. Clinical efficacy for tisagenlecleucel, SCR and BLN were based on pooled data from ELIANA, ENSIGN and B2101J trials, the study by von Stackelberg et al 2011, and MT103-205 respectively. Medical costs from pre-treatment until terminal care, including treatment, side effects, follow-up, subsequent allo-HSCT and relapse, were considered. Incremental cost-effectiveness ratios (ICERs) were estimated as the incremental costs per quality-adjusted life-year (QALY) gain. Additionally, the financial impact of tisagenlecleucel introduction in Singapore was estimated, comparing the present treatment scenario (without tisagenlecleucel) with a future scenario (with tisagenlecleucel), over 5 years.Results: In the base-case analysis, tisagenlecleucel treatment demonstrated cost-effectiveness with an ICER of S$45,840 (US$34,762) per QALY (vs SCR) and S$51,978 (US$39,315) per QALY (vs BLN). The estimated budget ranges from S$477,857 (US$361,438) to S$1.4 million (US$1.05 million) annually for the initial 5 years.Conclusion: Tisagenlecleucel is likely to be a cost-effective treatment option with limited budget implications while treating r/r ALL patients who have failed at least 2 lines of prior therapies.Keywords: tisagenlecleucel, acute lymphocytic leukemia, partition survival model, cost-effectiveness, budget impact, Singapore</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">tisagenlecleucel</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">acute lymphocytic leukemia</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">partition survival model</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">cost-effectiveness</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">budget impact</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">singapore</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Medicine (General)</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Therapeutics. 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callnumber-first	R - Medicine
author	Wang XJ
spellingShingle	Wang XJ misc R5-920 misc RM1-950 misc tisagenlecleucel misc acute lymphocytic leukemia misc partition survival model misc cost-effectiveness misc budget impact misc singapore misc Medicine (General) misc Therapeutics. Pharmacology Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective
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topic_title	R5-920 RM1-950 Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective tisagenlecleucel acute lymphocytic leukemia partition survival model cost-effectiveness budget impact singapore
topic	misc R5-920 misc RM1-950 misc tisagenlecleucel misc acute lymphocytic leukemia misc partition survival model misc cost-effectiveness misc budget impact misc singapore misc Medicine (General) misc Therapeutics. Pharmacology
topic_unstemmed	misc R5-920 misc RM1-950 misc tisagenlecleucel misc acute lymphocytic leukemia misc partition survival model misc cost-effectiveness misc budget impact misc singapore misc Medicine (General) misc Therapeutics. Pharmacology
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title	Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective
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title_full	Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective
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author_browse	Wang XJ Wang YH Ong MJC Gkitzia C Soh SY Hwang WYK
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title_sort	cost-effectiveness and budget impact analyses of tisagenlecleucel in pediatric and young adult patients with relapsed or refractory b-cell acute lymphoblastic leukemia from the singapore healthcare system perspective
callnumber	R5-920
title_auth	Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective
abstract	Xiao Jun Wang,1 Yi-Ho Wang,2 Matthew Jian Chun Ong,1 Christina Gkitzia,3 Shui Yen Soh,4 William Ying Khee Hwang5– 7 1Novartis Singapore Pte Ltd, Singapore; 2Novartis Asia Pacific Pharmaceuticals Pte Ltd, Singapore; 3Novartis Pharma AG, Basel, Switzerland; 4KK Women’s & Children’s Hospital, Singapore; 5National Cancer Centre Singapore, Singapore; 6Singapore General Hospital, Singapore; 7Duke-NUS Medical School, SingaporeCorrespondence: Xiao Jun Wang, Novartis Singapore Pte Ltd, 20 Pasir Panjang Road, #10-25/28 Mapletree Business City (West Tower), 117439, Singapore, Tel +65 67226010, Email nick-1.wangnovartis.comPurpose: Children and young adults with relapsed or refractory (r/r) acute lymphoblastic leukemia (ALL) have poor survival due to ineffective therapy options. The newly approved chimeric antigen receptor T-cell (CAR-T) therapy, tisagenlecleucel, has demonstrated improved survival but at a high up-front cost. The study aims to evaluate the cost-effectiveness and budget impact of tisagenlecleucel versus salvage chemotherapy regimen (SCR) or blinatumomab (BLN) for the treatment of pediatric and young adult patients with relapsed/refractory B-cell ALL from the Singapore healthcare system perspective.Patients and Methods: A three-health state partitioned survival model was constructed to analyze the cost-effectiveness of tisagenlecleucel vs SCR/BLN with/without allogenic hematopoietic stem cell transplantation (allo-HSCT) over a lifetime period. Clinical efficacy for tisagenlecleucel, SCR and BLN were based on pooled data from ELIANA, ENSIGN and B2101J trials, the study by von Stackelberg et al 2011, and MT103-205 respectively. Medical costs from pre-treatment until terminal care, including treatment, side effects, follow-up, subsequent allo-HSCT and relapse, were considered. Incremental cost-effectiveness ratios (ICERs) were estimated as the incremental costs per quality-adjusted life-year (QALY) gain. Additionally, the financial impact of tisagenlecleucel introduction in Singapore was estimated, comparing the present treatment scenario (without tisagenlecleucel) with a future scenario (with tisagenlecleucel), over 5 years.Results: In the base-case analysis, tisagenlecleucel treatment demonstrated cost-effectiveness with an ICER of S$45,840 (US$34,762) per QALY (vs SCR) and S$51,978 (US$39,315) per QALY (vs BLN). The estimated budget ranges from S$477,857 (US$361,438) to S$1.4 million (US$1.05 million) annually for the initial 5 years.Conclusion: Tisagenlecleucel is likely to be a cost-effective treatment option with limited budget implications while treating r/r ALL patients who have failed at least 2 lines of prior therapies.Keywords: tisagenlecleucel, acute lymphocytic leukemia, partition survival model, cost-effectiveness, budget impact, Singapore
abstractGer	Xiao Jun Wang,1 Yi-Ho Wang,2 Matthew Jian Chun Ong,1 Christina Gkitzia,3 Shui Yen Soh,4 William Ying Khee Hwang5– 7 1Novartis Singapore Pte Ltd, Singapore; 2Novartis Asia Pacific Pharmaceuticals Pte Ltd, Singapore; 3Novartis Pharma AG, Basel, Switzerland; 4KK Women’s & Children’s Hospital, Singapore; 5National Cancer Centre Singapore, Singapore; 6Singapore General Hospital, Singapore; 7Duke-NUS Medical School, SingaporeCorrespondence: Xiao Jun Wang, Novartis Singapore Pte Ltd, 20 Pasir Panjang Road, #10-25/28 Mapletree Business City (West Tower), 117439, Singapore, Tel +65 67226010, Email nick-1.wangnovartis.comPurpose: Children and young adults with relapsed or refractory (r/r) acute lymphoblastic leukemia (ALL) have poor survival due to ineffective therapy options. The newly approved chimeric antigen receptor T-cell (CAR-T) therapy, tisagenlecleucel, has demonstrated improved survival but at a high up-front cost. The study aims to evaluate the cost-effectiveness and budget impact of tisagenlecleucel versus salvage chemotherapy regimen (SCR) or blinatumomab (BLN) for the treatment of pediatric and young adult patients with relapsed/refractory B-cell ALL from the Singapore healthcare system perspective.Patients and Methods: A three-health state partitioned survival model was constructed to analyze the cost-effectiveness of tisagenlecleucel vs SCR/BLN with/without allogenic hematopoietic stem cell transplantation (allo-HSCT) over a lifetime period. Clinical efficacy for tisagenlecleucel, SCR and BLN were based on pooled data from ELIANA, ENSIGN and B2101J trials, the study by von Stackelberg et al 2011, and MT103-205 respectively. Medical costs from pre-treatment until terminal care, including treatment, side effects, follow-up, subsequent allo-HSCT and relapse, were considered. Incremental cost-effectiveness ratios (ICERs) were estimated as the incremental costs per quality-adjusted life-year (QALY) gain. Additionally, the financial impact of tisagenlecleucel introduction in Singapore was estimated, comparing the present treatment scenario (without tisagenlecleucel) with a future scenario (with tisagenlecleucel), over 5 years.Results: In the base-case analysis, tisagenlecleucel treatment demonstrated cost-effectiveness with an ICER of S$45,840 (US$34,762) per QALY (vs SCR) and S$51,978 (US$39,315) per QALY (vs BLN). The estimated budget ranges from S$477,857 (US$361,438) to S$1.4 million (US$1.05 million) annually for the initial 5 years.Conclusion: Tisagenlecleucel is likely to be a cost-effective treatment option with limited budget implications while treating r/r ALL patients who have failed at least 2 lines of prior therapies.Keywords: tisagenlecleucel, acute lymphocytic leukemia, partition survival model, cost-effectiveness, budget impact, Singapore
abstract_unstemmed	Xiao Jun Wang,1 Yi-Ho Wang,2 Matthew Jian Chun Ong,1 Christina Gkitzia,3 Shui Yen Soh,4 William Ying Khee Hwang5– 7 1Novartis Singapore Pte Ltd, Singapore; 2Novartis Asia Pacific Pharmaceuticals Pte Ltd, Singapore; 3Novartis Pharma AG, Basel, Switzerland; 4KK Women’s & Children’s Hospital, Singapore; 5National Cancer Centre Singapore, Singapore; 6Singapore General Hospital, Singapore; 7Duke-NUS Medical School, SingaporeCorrespondence: Xiao Jun Wang, Novartis Singapore Pte Ltd, 20 Pasir Panjang Road, #10-25/28 Mapletree Business City (West Tower), 117439, Singapore, Tel +65 67226010, Email nick-1.wangnovartis.comPurpose: Children and young adults with relapsed or refractory (r/r) acute lymphoblastic leukemia (ALL) have poor survival due to ineffective therapy options. The newly approved chimeric antigen receptor T-cell (CAR-T) therapy, tisagenlecleucel, has demonstrated improved survival but at a high up-front cost. The study aims to evaluate the cost-effectiveness and budget impact of tisagenlecleucel versus salvage chemotherapy regimen (SCR) or blinatumomab (BLN) for the treatment of pediatric and young adult patients with relapsed/refractory B-cell ALL from the Singapore healthcare system perspective.Patients and Methods: A three-health state partitioned survival model was constructed to analyze the cost-effectiveness of tisagenlecleucel vs SCR/BLN with/without allogenic hematopoietic stem cell transplantation (allo-HSCT) over a lifetime period. Clinical efficacy for tisagenlecleucel, SCR and BLN were based on pooled data from ELIANA, ENSIGN and B2101J trials, the study by von Stackelberg et al 2011, and MT103-205 respectively. Medical costs from pre-treatment until terminal care, including treatment, side effects, follow-up, subsequent allo-HSCT and relapse, were considered. Incremental cost-effectiveness ratios (ICERs) were estimated as the incremental costs per quality-adjusted life-year (QALY) gain. Additionally, the financial impact of tisagenlecleucel introduction in Singapore was estimated, comparing the present treatment scenario (without tisagenlecleucel) with a future scenario (with tisagenlecleucel), over 5 years.Results: In the base-case analysis, tisagenlecleucel treatment demonstrated cost-effectiveness with an ICER of S$45,840 (US$34,762) per QALY (vs SCR) and S$51,978 (US$39,315) per QALY (vs BLN). The estimated budget ranges from S$477,857 (US$361,438) to S$1.4 million (US$1.05 million) annually for the initial 5 years.Conclusion: Tisagenlecleucel is likely to be a cost-effective treatment option with limited budget implications while treating r/r ALL patients who have failed at least 2 lines of prior therapies.Keywords: tisagenlecleucel, acute lymphocytic leukemia, partition survival model, cost-effectiveness, budget impact, Singapore
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title_short	Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective
url	https://doaj.org/article/80d37a3c65b74bbb8a62a00fb75a86d1 https://www.dovepress.com/cost-effectiveness-and-budget-impact-analyses-of-tisagenlecleucel-in-p-peer-reviewed-fulltext-article-CEOR https://doaj.org/toc/1178-6981
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The newly approved chimeric antigen receptor T-cell (CAR-T) therapy, tisagenlecleucel, has demonstrated improved survival but at a high up-front cost. The study aims to evaluate the cost-effectiveness and budget impact of tisagenlecleucel versus salvage chemotherapy regimen (SCR) or blinatumomab (BLN) for the treatment of pediatric and young adult patients with relapsed/refractory B-cell ALL from the Singapore healthcare system perspective.Patients and Methods: A three-health state partitioned survival model was constructed to analyze the cost-effectiveness of tisagenlecleucel vs SCR/BLN with/without allogenic hematopoietic stem cell transplantation (allo-HSCT) over a lifetime period. Clinical efficacy for tisagenlecleucel, SCR and BLN were based on pooled data from ELIANA, ENSIGN and B2101J trials, the study by von Stackelberg et al 2011, and MT103-205 respectively. Medical costs from pre-treatment until terminal care, including treatment, side effects, follow-up, subsequent allo-HSCT and relapse, were considered. Incremental cost-effectiveness ratios (ICERs) were estimated as the incremental costs per quality-adjusted life-year (QALY) gain. Additionally, the financial impact of tisagenlecleucel introduction in Singapore was estimated, comparing the present treatment scenario (without tisagenlecleucel) with a future scenario (with tisagenlecleucel), over 5 years.Results: In the base-case analysis, tisagenlecleucel treatment demonstrated cost-effectiveness with an ICER of S$45,840 (US$34,762) per QALY (vs SCR) and S$51,978 (US$39,315) per QALY (vs BLN). The estimated budget ranges from S$477,857 (US$361,438) to S$1.4 million (US$1.05 million) annually for the initial 5 years.Conclusion: Tisagenlecleucel is likely to be a cost-effective treatment option with limited budget implications while treating r/r ALL patients who have failed at least 2 lines of prior therapies.Keywords: tisagenlecleucel, acute lymphocytic leukemia, partition survival model, cost-effectiveness, budget impact, Singapore</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">tisagenlecleucel</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">acute lymphocytic leukemia</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">partition survival model</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">cost-effectiveness</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">budget impact</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">singapore</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Medicine (General)</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Therapeutics. 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Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective

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