Cost-effectiveness of Enasidenib versus conventional care for older patients with <i>IDH2-</i> mutant refractory/relapsed AML
In the randomized phase III IDHENTIFY trial, the IDH2 inhibitor enasidenib (ENA) showed improvement in event-free but not overall survival compared with conventional care regimens (CCR) among patients with relapsed/refractory (R/R), <i>IDH2</i>-mutant AML. We constructed a partitioned survival model to evaluate the cost-effectiveness of enasidenib for the treatment of older patients with R/R, and <i>IDH2</i>-mutant AML. In the base-case scenario, ENA exhibited an incremental effectiveness of 0.234quality-adjusted life-years (QALYs) compared to CCR, and an incremental cost of $126,800, leading to an incremental cost-effectiveness ratio of $540,300/QALY(95% CI: $197,800-$4,777,000/QALY). In probabilistic sensitivity analysis, CCR was favored in 99.8% of simulations. The cost of ENA would need to be decreased by 72% to be cost-effective at a willingness-to-pay threshold of $150,000/QALY. Our findings suggest that ENA is unlikely to be a cost-effective treatment for older patients with <i>IDH2-</i>mutant R/R AML under current pricing.
Authors
- George Goshua (ORCID: https://orcid.org/0000-0002-1624-4427)
- Maximilian Stahl (ORCID: https://orcid.org/0000-0002-1299-5901)
- Nikolai Alexandrovich Podoltsev (ORCID: https://orcid.org/0000-0002-3657-778X)
- Scott F. Huntington (ORCID: https://orcid.org/0000-0001-7071-6475)
- Tariq Zuheir Kewan (ORCID: https://orcid.org/0000-0003-4651-5125)
- Kishan Patel (ORCID: https://orcid.org/0000-0002-6163-3069)
- Jessica M. Stempel (ORCID: https://orcid.org/0000-0001-9162-0579)
- Abdulrahman Alhajahjeh (ORCID: https://orcid.org/0000-0001-5264-8990)
- Amer Methqal Zeidan (ORCID: https://orcid.org/0000-0001-7017-8160)
- Lourdes Mendez (ORCID: https://orcid.org/0000-0002-5922-2877)
- Jan Philipp Bewersdorf (ORCID: https://orcid.org/0000-0003-3352-0902)
- Rory Michael Shallis (ORCID: https://orcid.org/0000-0002-8542-2944)
Institutions
- University of Jordan (JO)
- Yale New Haven Hospital (US)
- Memorial Sloan Kettering Cancer Center (US)
- Harvard University (US)
- King Hussein Cancer Center (JO)
- Yale University (US)
- Dana-Farber Cancer Institute (US)
Publication Details
- Journal
- Leukemia & lymphoma/Leukemia and lymphoma
- Published
- 2024-11-19
- DOI
- https://doi.org/10.1080/10428194.2024.2426073
- Citations
- 1
- Primary Topic
- Acute Myeloid Leukemia Research
- Type
- article
- Field-Weighted Citation Impact
- 0.45
Funders
- Edward P. Evans Foundation
- Frederick A. DeLuca Foundation
- Instituto Nacional de Cancerología
- NOMIS Stiftung
- National Heart, Lung, and Blood Institute