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Pharmacogenomics ; 19(3): 213-226, 2018 02.
Article in English | MEDLINE | ID: mdl-29334316

ABSTRACT

Biomarkers associated with prognosis in multiple myeloma (MM) can be used to stratify patients into risk categories. An attractive alternative to uniform treatment (UT), risk-stratified treatment (RST) is proposed where high-risk patients receive bortezomib-based regimens while standard-risk patients receive alternative less costly regimens. An early Markov-type decision analytic model evaluated the potential therapeutic and economic value of different RST strategies compared with UT in MM patients in key European countries. Results suggest RST strategies were both cheaper and more effective than UT across all countries, with the molecular marker-only strategy RST-SKY92 producing maximum health gains (0.031-0.039 QALYs). The conclusions remained consistent in the univariate sensitivity analyses. These findings should encourage stakeholders to support the adoption of RST approaches in MM.


Subject(s)
Antineoplastic Agents/economics , Bortezomib/economics , Health Care Costs , Models, Economic , Multiple Myeloma/drug therapy , Multiple Myeloma/economics , Antineoplastic Agents/therapeutic use , Biomarkers, Tumor/analysis , Biomarkers, Tumor/economics , Bortezomib/therapeutic use , Cost-Benefit Analysis , Decision Support Techniques , Europe , Humans , Kaplan-Meier Estimate , Markov Chains , Multiple Myeloma/mortality , Quality-Adjusted Life Years
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