Cost-effectiveness of autologous bone marrow transplantation in patients with relapsed non-Hodgkin’s lymphoma

Abstract

The analysis of published survival curves can be used as the basis for conducting cost-effectiveness analyses in which two treatments are compared in terms of cost per life year saved. In patients with relapsed chemosensitive non-Hodgkin’s lymphoma, autologous bone marrow transplantation (ABMT) has been reported to improve survival in comparison with control patients who receive standard chemotherapy. An incremental cost-effectiveness analysis was undertaken in which the Gompertz model was used to determine a lifetime estimate of patient-years gained by subjects given ABMT in comparison with controls. Our study utilised the cost data calculated by Uyl-de Groot et al and the clinical data reported by Philip et al. This latter randomised clinical trial involved 55 patients subjected to ABMT and 54 controls given chemotherapy. Lifetime survival advantage for patients of the ABMT group was estimated as 3606 discounted patient-months every 100 patients. The use of ABMT as opposed to standard chemotherapy was found to imply an incremental cost of $9,229 per discounted life year gained (95% CI of $5390 to $24012). The cost-effectiveness ratio of ABMT in patients with relapsed chemosensitive non-Hodgkin’s lymphoma is noticeably favourable.