Cost-Utility analysis of Dinutuximab Beta in Treating High-Risk Neuroblastoma: A Partitioned Survival Model Using R programming Language
Author(s)
Khader Al-Habash, PharmD1, Wael M. Mohammed, PhD Candidate2, Razan D. Sawalha, MSc(HealthEcon)1, TALA M. Asha, PharmD1, Hadeel Halalsheh, MD3, Iyad Sultan, MD3, Saad Jaddouh, BS,RPh3, Abeer A. Al Rabayah, MBA, MSc1;
1King Hussein Cancer Center, Center for Drug Policy & Technology Assessment, Amman, Jordan, 2sheffield university, sheffield, United Kingdom, 3King Hussein Cancer Center, Amman, Jordan
1King Hussein Cancer Center, Center for Drug Policy & Technology Assessment, Amman, Jordan, 2sheffield university, sheffield, United Kingdom, 3King Hussein Cancer Center, Amman, Jordan
OBJECTIVES: This study aimed to assess the cost utility of Dinutuximab beta for the treatment of high risk neuroblastoma pediatric patients compared to standard of care from the perspective of the Jordanian healthcare system
METHODS: This is a model-based study where patients were simulated to generate the expected cost, Life Years (LYs), and quality adjusted life years (QALYs) for the intervention (Dinutuximab beta with Isotretinoin) and the comparator (Isotretinoin). We applied a three-health state partitioned survival analysis model with a cycle length of one month at a time horizon of 10 years. Cost and outcomes were discounted using a 3% discount rate. Input parameters were taken from literature, national databases, and primary collected patients’ data. Uncertainty was tested using both deterministic and probabilistic sensitivity analysis. The model was built using the R programming language.
RESULTS: Dinutuximab beta was associated with a projected total mean discounted cost of 267,051 JOD, a total mean discounted LYs of 6.15 and a total mean discounted QALYs of 4.88. The comparator Isotretinoin was associated with projected total mean discounted cost of 13,571 JOD, a total mean discounted LYs of 5.8 and a total mean discounted QALYs of 4.51. Compared with Isotretinoin, Dinutuximab beta generated 0.35 more LYs, 0.37 more QALYs with an increased cost of 253,480 JOD. The resulted deterministic Incremental Cost Utility Ratio (ICUR) was 684,174 JOD/QALY and the probabilistic ICUR was 669,318 JD/QALY. The deterministic sensitivity analysis showed that the ICUR was mostly sensitive to the price of Dinutuximab beta, followed by utility values.
CONCLUSIONS: Dinutuximab beta is not a cost effective option compared to Isotretinoin at a threshold value of 40,000 JOD per QALY from a Jordanian health care system perspective. Price negotiations including customized risk sharing agreements are required to improve the value and affordability of Dinutuximab beta.
METHODS: This is a model-based study where patients were simulated to generate the expected cost, Life Years (LYs), and quality adjusted life years (QALYs) for the intervention (Dinutuximab beta with Isotretinoin) and the comparator (Isotretinoin). We applied a three-health state partitioned survival analysis model with a cycle length of one month at a time horizon of 10 years. Cost and outcomes were discounted using a 3% discount rate. Input parameters were taken from literature, national databases, and primary collected patients’ data. Uncertainty was tested using both deterministic and probabilistic sensitivity analysis. The model was built using the R programming language.
RESULTS: Dinutuximab beta was associated with a projected total mean discounted cost of 267,051 JOD, a total mean discounted LYs of 6.15 and a total mean discounted QALYs of 4.88. The comparator Isotretinoin was associated with projected total mean discounted cost of 13,571 JOD, a total mean discounted LYs of 5.8 and a total mean discounted QALYs of 4.51. Compared with Isotretinoin, Dinutuximab beta generated 0.35 more LYs, 0.37 more QALYs with an increased cost of 253,480 JOD. The resulted deterministic Incremental Cost Utility Ratio (ICUR) was 684,174 JOD/QALY and the probabilistic ICUR was 669,318 JD/QALY. The deterministic sensitivity analysis showed that the ICUR was mostly sensitive to the price of Dinutuximab beta, followed by utility values.
CONCLUSIONS: Dinutuximab beta is not a cost effective option compared to Isotretinoin at a threshold value of 40,000 JOD per QALY from a Jordanian health care system perspective. Price negotiations including customized risk sharing agreements are required to improve the value and affordability of Dinutuximab beta.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE213
Topic
Economic Evaluation
Disease
SDC: Oncology, SDC: Pediatrics