Cost-utility analysis of pralatrexate for relapsed or refractory peripheral T-cell lymphoma based on a case-matched historical control study along with single arm clinical trial

Seonyoung Park, Ah Young Kim, Hyeonseok Cho, Deborah Baik, Hankil Lee, Sunghwa Cho, Hye Young Kang

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patients with relapsed or refractory peripheral T-cell lymphoma (R/R PTCL) treated with pralatrexate have previously shown superior overall survival (OS) compared to those who underwent conventional chemotherapy (CC, 15.4 vs. 4.07 months). We conducted an economic evaluation of pralatrexate from a societal perspective in Korea based on data from the PROPEL phase II study. Methods: Using a Markov model with a weekly cycle, we simulated the experience of patients with R/R PTCL receiving pralatrexate or CC for 15 years. The model consists of five health states; initial treatment, treatment pause, subsequent treatment, stem cell transplantation (SCT) success, and death. Comparative effectiveness was based on PROPEL phase II single-arm study and its matched historical control analysis. Costs included drug, drug administration, monitoring, adverse event management, and SCT costs. Results: The incremental cost-effectiveness ratio of the base case was $39,153 per quality-adjusted life-year (QALY) gained. The results of one-way sensitivity analysis ranged from $33,949 to $51,846 per QALY gained, which remained within an implicit willingness-to-pay (WTP) threshold of anticancer drugs in Korea. Conclusions: Pralatrexate is a cost-effective intervention with improved OS and incremental costs within the WTP limit. Pralatrexate could function as a new therapeutic option for patients suffering from life-threatening R/R PTCL.

Original languageEnglish
Article number1157
JournalBMC cancer
Volume20
Issue number1
DOIs
Publication statusPublished - 2020 Dec

Bibliographical note

Funding Information:
The co-authors express their appreciation for the support received from the expert panel consisting of Dok Hyun Yoon, M.D., Ph.D. of the University of Ulsan College of Medicine, Seok-Goo Cho, M.D., Ph.D. of the Catholic University of Korea College of Medicine, Hyeon-Seok Eom, M.D., Ph.D. of the National Cancer Center, Won Seog Kim, M.D., Ph.D. of the Sungkyunkwan University School of Medicine, Ho-Jin Shin, M.D., Ph.D. of the Pusan National University School of Medicine, and Deok-Hwan Yang, M.D., Ph.D. of the Chonnam National University School of Medicine.

Funding Information:
This work was supported by an unrestricted grant from Mundipharma Korea Ltd. (grant number 2018-11-1317). The funding source had no involvement in the study design; the collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the article for publication.

Publisher Copyright:
© 2020, The Author(s).

All Science Journal Classification (ASJC) codes

  • Genetics
  • Oncology
  • Cancer Research

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