COST-UTILITY ANALYSIS OF MELPHALAN PLUS PREDNISONE WITH OR WITHOUT INTERFERON-ALPHA-2B IN NEWLY-DIAGNOSED MULTIPLE-MYELOMA - RESULTS FROM ARANDOMIZED CONTROLLED TRIAL

This study evaluated the cost utility of adding interferon-alpha 2b to conventional treatment in patients with multiple myeloma. It also pro vides a methodology for transforming complex quality-of-life profiles into a single index value on the conventional 0 to 1 quality-adjusted life-year scale (QALY). From 1990 to 1992, 583 patients with newly dia gnosed, symptomatic multiple myeloma were enrolled in a randomised, mu lticentre, phase III study to evaluate the addition of interferon-alph a 2b to treatment with melphalan and prednisone.Addition of interferon -alpha 2b yielded a 12% increase in median survival time, at the expen se of a slight reduction in quality of life during the first year of t reatment. The gain in survival time was not large enough to reach stat istical significance. Patients receiving interferon-alpha 2b also had a 5- to 6-month prolongation of the plateau phase. Cost per QALY gaine d by adding interferon-alpha 2b was conservatively estimated at $US110 000. Potentially better cost effectiveness may be found in different treatment regimens or in certain patient subgroups.