Cost-utility analysis of high-dose melphalan with autologous blood stem cell support vs. melphalan plus prednisone in patients younger than 60 years with multiple myeloma
N. Gulbrandsen et al., Cost-utility analysis of high-dose melphalan with autologous blood stem cell support vs. melphalan plus prednisone in patients younger than 60 years with multiple myeloma, EUR J HAEMA, 66(5), 2001, pp. 328-336
We evaluated the costs and the cost utility of high-dose melphalan and auto
logous stem cell support followed by interferon maintenance relative to con
ventional treatment with melphalan and prednisone, in patients less than 60
yr of age with multiple myeloma. From March 1994 to July 1997, 274 patient
s with newly diagnosed, symptomatic multiple myeloma were enrolled in a pro
spective, nonrandomized, population-based, multicenter study to evaluate th
e treatment with high-dose melphalan and autologous blood stem cell support
. Health-related quality-of-life was measured prior to treatment and during
follow-up, using the EORTC QLQ-C30 questionnaire. Resource consumption was
also recorded prospectively. The intensive treatment yielded a significant
increase in median survival time from 44 to 62 months compared to conventi
onally treated patients. The corresponding gain in quality-adjusted life ye
ars (QALY) was found to be 1.2. Cost per QALY gained by the treatment with
high-dose melphalan and autologous blood stem cell support was estimated at
NOK 249,000 (USD 27,000).