Pan-European multicentre economic evaluation of recombinant urate oxidase (rasburicase) in prevention and treatment of hyperuricaemia and tumour lysis syndrome in haematological cancer patients

Hyperuricaemia (HU) and tumour lysis syndrome (TLS) are complications of acute myeloid/lymphoid leukaemia (AML/ALL) and non-Hodgkin lymphoma (NHL) leading to increased morbidity and mortality. The objective was to assess incremental cost-effectiveness ratios (ICER) of preventing/treating HU and TLS...

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Bibliographic Details
Published in:Supportive care in cancer 2003-04, Vol.11 (4), p.249-257
Main Authors: ANNEMANS, L, MOEREMANS, K, LAMOTTE, M, GARCIA CONDE, J, BERG, H, MYINT, H, PIETERS, R, UYTTEBROECK, A
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Child
Child, Preschool
Clinical trials
Cost of Illness
Cost-Benefit Analysis
Drug Costs - statistics & numerical data
Europe - epidemiology
General and cellular metabolism. Vitamins
Hematologic Neoplasms - drug therapy
Humans
Hyperuricemia - drug therapy
Hyperuricemia - economics
Hyperuricemia - epidemiology
Incidence
Leukemia - drug therapy
Lymphoma, Non-Hodgkin - drug therapy
Medical research
Medical sciences
Middle Aged
Outcome and Process Assessment (Health Care)
Pharmacology. Drug treatments
Prognosis
Retrospective Studies
Survival Rate
Treatment Outcome
Tumor Lysis Syndrome - drug therapy
Tumor Lysis Syndrome - economics
Tumor Lysis Syndrome - epidemiology
Urate Oxidase - economics
Urate Oxidase - therapeutic use
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Summary:Hyperuricaemia (HU) and tumour lysis syndrome (TLS) are complications of acute myeloid/lymphoid leukaemia (AML/ALL) and non-Hodgkin lymphoma (NHL) leading to increased morbidity and mortality. The objective was to assess incremental cost-effectiveness ratios (ICER) of preventing/treating HU and TLS with recombinant urate oxidase, rasburicase (Fasturtec/Elitek). Incidence and costs of HU and TLS were based on a multi-country chart review. Life expectancy at the time of diagnosis was based on published survival rates and age at diagnosis. Reductions of HU/TLS following treatment with rasburicase were based on clinical trial data. Prevention with rasburicase appears highly cost-effective in children (ICER between Eur 425 and Eur 3054 per life-year saved, LYS). In adults, prevention is more cost-effective in NHL and ALL (maximum ICER of Eur 41383 and Eur 32126 per LYS). Treatment of established HU/TLS with rasburicase is cost-saving in children and highly cost-effective in adults. The results are robust in children. In adults, the prevention strategy appears sensitive to the risk of HU/TLS. In conclusion, rasburicase, in addition to the demonstrated clinical benefit, is an economically attractive new option in the treatment of HU, both in adults and children. In prevention the drug has an attractive economic profile in children, and is cost-effective in adults with ALL and NHL.
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-002-0435-3