A systematic review of economic evaluations for the pharmaceutical treatment of chronic lymphocytic leukemia and acute myeloid leukemia

ABSTRACT

Introduction

No recent full-text-based systematic review has been published to examine economic evidence around acute myeloid leukemia (AML) or chronic lymphocytic leukemia (CLL) treatment. We aimed to perform a systematic review in this area.

Areas covered

This review entailed searches in three main databases for economic evaluations of treatment in AML or CLL. After title and abstract screening, two reviewers examined all the citations in full text. Any disagreement between the two reviewers was resolved through discussion with the third reviewer. We used predesigned tools for data extraction, including study characteristics, primary results and conclusions. The quality of included studies was assessed.

Expert opinion

The majority of the studies adopted the modeling approach to estimate the long-term cost-effectiveness of the treatment from the healthcare system payer’s perspective. Most studies concluded that the evaluated treatment interventions for untreated or refractory AML or CLL were cost-effective across various jurisdictions. The EQ-5D, followed by time trade-off and standard-gamble, was the most commonly used outcome measure to derive the utility weights associated with each health state. Clear justifications for the choice of modeling technique are recommended for future studies. Collecting the health-related quality of life outcome using a common instrument over the clinical trial could aid the comparability among economic studies.

KEYWORDS:

• Acute myeloid leukemia (AML)
• chronic lymphocytic leukemia (CLL)
• cost-effectiveness analysis
• treatment
• systematic review

Article highlights

• The majority of the studies adopted the modeling approach to estimate the long-term cost-effectiveness of the treatment from the healthcare system payer’s perspective

• Most studies concluded that the evaluated treatment interventions for untreated or refractory AML or CLL were cost-effective

• Markov and partitioned survival models are the most used modeling techniques

• The overall quality of the published cost-effectiveness analysis was good

• It is recommended that health economists need carefully consider and justify the appropriate modeling techniques

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17474086.2022.2125376