Evidence map›Paper›PMID 35468783›Full record

ArticleBMC health services research2022

Adding rituximab to chemotherapy for diffuse large B-cell lymphoma patients in Indonesia: a cost utility and budget impact analysis.

Septiara Putri, Ery Setiawan, Siti Rizny F Saldi, Levina Chandra Khoe, Euis Ratna Sari, Amila Megraini, Mardiati Nadjib, Sudigdo Sastroasmoro, Armansyah Armansyah

Abstract read
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
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

9 authors.

Septiara PutriHealth Policy and Administration Department, Faculty of Public Health, University of Indonesia, Depok, West Java, 16424, Indonesia. septiaraputri@ui.ac.id.
Ery SetiawanCenter for Health Economics and Policy Studies (CHEPS) University of Indonesia, Depok, West Java, 16424, Indonesia.
Siti Rizny F SaldiCenter for Clinical Epidemiology and Evidence Based Medicine (CEEBM) Cipto Mangunkusomo Hospital, Jakarta, 10430, Indonesia.
Levina Chandra KhoeCommunity Medicine Department, Faculty of Medicine University of Indonesia, Jakarta, 10430, Indonesia.
Euis Ratna SariCenter for Health Economics and Policy Studies (CHEPS) University of Indonesia, Depok, West Java, 16424, Indonesia.
Amila MegrainiCenter for Health Economics and Policy Studies (CHEPS) University of Indonesia, Depok, West Java, 16424, Indonesia.
Mardiati NadjibIndonesian Health Technology Assessment Committee, Jakarta, 12950, Indonesia.
Sudigdo SastroasmoroIndonesian Health Technology Assessment Committee, Jakarta, 12950, Indonesia.
Armansyah ArmansyahCenter for Health Financing and Insurance, Ministry of Health Republic of Indonesia, Jakarta, 12950, Indonesia.

Funding

BPJS Kesehatan 370/KTR/0818
6 · The paper itself

Abstract

backgroundRituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) has been used to treat patients with diffuse large B-cell lymphoma (DLBCL) under National Health Insurance (NHI) scheme in Indonesia. This study aims to estimate its cost-effectiveness and budget impact.

methodsWe conducted a cost utility analysis using Markov model over a lifetime horizon, from a societal perspective. Clinical evidence was derived from published clinical trials. Direct medical costs were gathered from hospital data. Direct non-medical costs, indirect costs, and utility data were primarily gathered by interviewing the patients. We applied 3% discount rate for both costs and effect. All monetary data are converted into USD (1 USD = IDR 14,000, 2019). Probabilistic sensitivity analysis was performed. In addition, from a payer perspective, budget impact analysis was estimated using price reduction scenarios.

resultsThe incremental cost-effectiveness ratio (ICER) of R-CHOP was USD 4674/LYG and 9280/QALY. If we refer to the threshold three times the GDP per capita (USD 11,538), R-CHOP could thus be determined as a cost-effective therapy. Its significant health benefit has contributed to the considerable ICER result. Although the R-CHOP has been considered a cost-effective intervention, the financial consequence of R-CHOP if remain in benefit package under National Health Insurance (NHI) system in Indonesia is considerably substantial, approximately USD 35.00 million with 75% price reduction scenario.

conclusionsAs a favorable treatment for DLBCL, R-CHOP ensures value for money in Indonesia. Budget impact analysis provides results which can be used as further consideration for decision-makers in matters related to benefit packages.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsLymphoma, Large B-Cell, DiffuseAntibodies, Monoclonal, Murine-DerivedCost-Benefit AnalysisCyclophosphamideDoxorubicinHumansIndonesiaPrednisoneRituximabVincristineAntibodies, Monoclonal, Murine-DerivedCyclophosphamideDoxorubicinPrednisoneRituximabVincristineCost-effectivenessDLBCLLymphomaRituximab

Identifiers

PMID35468783
PMCPMC9040215

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LicenceCC BY
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Registered trials

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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.