Cost-effectiveness analysis of interferon as adjuvant therapy in high-riskmelanoma patients in Spain

In the randomised clinical trial E1684, the administration of interferon (I FN) alpha-2b resulted in prolonged disease-free and overall survival in hig h-risk melanoma patients following surgical resection. However, and conside ring the cost and toxicity of IFN, the convenience of its widespread use sh ould be evaluated. The aim of this study was to analyse the cost-effectiven ess ratio of adjuvant therapy with IFN alpha-2b in melanoma patients versus an untreated control group. A Markov model was used to compare two hypothe tical cohorts of 1000 patients aged 50 years, according to the clinical out come of the E1684 study, The cohort of patients treated with IFN alpha-2b h as an increased overall survival of 1.90 years during the patient's lifetim e. The incremental discounted cost per life year gained of IFN versus obser vation is 9015 Euros according to the projection generated by the model. Th e sensitivity analysis demonstrated that changes in the most relevant study end-points do not modify the study outcome. In conclusion, in high-risk me lanoma patients following surgical resection, the cost-effectiveness of IFN alpha-2b (at a dose of 20 MU/m(2)/day, 5 days per week for one month, foll owed by 10 MU/m(2) TIW, up to one complete year of therapy) versus an untre ated control group is within the limits established in health economics to determine if adoption of a new treatment is economically justified and is c omparable with other interventions in which cost-effectiveness is acceptabl e to the National Health System. (C) 2000 Elsevier Science Ltd. All rights reserved.