Evidence map›Paper›PMID 32952707›Full record

ArticleZdravstveno varstvo2020

Long-Term Effectiveness and Cost Effectiveness of Multiple Myeloma Treatment Strategies for Elderly Transplant-Ineligible Patients in Serbia.

Đurđa Vukićević, Ursula Rochau, Aleksandar Savić, Monika Schaffner, Milica Jevđević, Igor Stojkov, Gaby Sroczynski, Wolfgang Willenbacher, Beate Jahn, Uwe Siebert

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In one paragraph

Article in Zdravstveno varstvo, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Đurđa VukićevićUMIT - University for Health Sciences, Medical Informatics and Technology, Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and HTA, Eduard Wallnöfer Zentrum 1, Hall in Tirol, 6060 Austria.
Ursula RochauUMIT - University for Health Sciences, Medical Informatics and Technology, Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and HTA, Eduard Wallnöfer Zentrum 1, Hall in Tirol, 6060 Austria.
Aleksandar SavićUniversity of Novi Sad, Faculty of Medicine, Clinical Center of Vojvodina, Clinic for Hematology, Serbia.
Monika SchaffnerUMIT - University for Health Sciences, Medical Informatics and Technology, Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and HTA, Eduard Wallnöfer Zentrum 1, Hall in Tirol, 6060 Austria.
Milica JevđevićUMIT - University for Health Sciences, Medical Informatics and Technology, Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and HTA, Eduard Wallnöfer Zentrum 1, Hall in Tirol, 6060 Austria.
Igor StojkovUMIT - University for Health Sciences, Medical Informatics and Technology, Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and HTA, Eduard Wallnöfer Zentrum 1, Hall in Tirol, 6060 Austria.
Gaby SroczynskiUMIT - University for Health Sciences, Medical Informatics and Technology, Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and HTA, Eduard Wallnöfer Zentrum 1, Hall in Tirol, 6060 Austria.
Wolfgang WillenbacherMedical University, Internal Medicine V, Hematology and Oncology, Innsbruck, Austria.
Beate JahnUMIT - University for Health Sciences, Medical Informatics and Technology, Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and HTA, Eduard Wallnöfer Zentrum 1, Hall in Tirol, 6060 Austria.
Uwe SiebertArea 4 Health Technology Assessment and Bioinformatics, ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEvidence on long-term effectiveness and cost effectiveness of treatment sequences for multiple myeloma (MM) is sparse. We used published data and country-specific data to assess the cost effectiveness of four-line treatment sequences for elderly transplant-ineligible patients with MM in Serbia.

methodWe developed a Markov cohort model to compare long-term effectiveness and cost effectiveness of five sequential MM treatment alternatives from the perspective of the national healthcare provider. Effectiveness parameters on progression, mortality and adverse events were extracted from published clinical trials. Costs were based on price lists of the National Health Insurance Fund. We compared life expectancy, costs, and incremental cost-effectiveness ratios among alternative courses of action. The model was analyzed over a lifelong time horizon applying a 3% annual discount rate for effectiveness outcomes and costs. Robustness of the model was tested in multiple deterministic sensitivity analyses.

resultsThe sequences were defined by the frontline treatment: MPT (melphalan-prednisone-thalidomide), MPV (melphalanprednisone-bortezomib), CTD (cyclophosphamide-thalidomide-dexamethasone), VCD (bortezomib-cyclophosphamidedexamethasone) and BP (bendamustine-prednisone). MPV sequence resulted in the highest remaining life expectancy (4.76 life years). Cost-effectiveness analysis resulted in three non-dominated strategies: MPT, VCD, and MPV sequences, with an incremental cost-effectiveness ratio of EUR 35,300 per life-year gained (LYG) for VCD and EUR 47,200/LYG for MPV relative to MPT.

conclusionMPV sequence was the most effective in terms of life expectancy for elderly transplant-ineligible MM patients in Serbia. Bortezomib-based strategies would be recommended for the frontline treatment of patients with MM in Serbia if the willingness-to-pay threshold is around EUR 35,000-60,000/LYG.

Indexed as

cost effectivenesslong-term effectivenessmultiple myelomasequential treatment

Identifiers

PMID32952707
PMCPMC7478073

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.