Cost-Effectiveness of the treatment protocols of  pediatrics with Acute Lymphoblastic Leukemia  (Decision tree modelling)

Hadi  Hayati; Mohammad Ali Ehsani

doi:10.18502/jppm.v10i1.15397

Hadi Hayati Department of Pharmacoeconomics and Management, School of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, Iran
Mohammad Ali Ehsani Department. of Pediatric Hematology and Oncology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jppm.v10i1.15397

Keywords: Cancer management, Cost, Acute Lymphoblastic Leukemia, Children, Cost-Effectiveness analysis, Decision Tree modelling, BFM-ALL, UKALL, QALY

Abstract

Background: Acute lymphoblastic leukemia (ALL) has a high prevalence at early age and in children and regard to life expectancy index this disease cause to losing many years of life in these patients. Two well-known European protocols called United Kingdom (UK-ALL) and Berlin-Frankfurt-Munster (BFM-ALL) protocols are used to treat the disease in most countries of the world and in Iran, so the objective of this study is modelling of the treatment process using both protocols to estimate more cost-effectiveness method.

Methods: A decision tree model was applied to depict the real treatment process to calculate costs per quality-adjusted life-year (QALY). Total costs were included to the model.

Results: The cost effectiveness ratio of UK-ALL is lower than BFM-ALL (1145.52 USD /3.87 QALY for UK-ALL and 1942.35 USD /3.02 QALY for BFM-ALL). Therefore, the UK-ALL is dominant and BFM-ALL is dominated.

Conclusion: The modeling results showed a double difference between the two studied options so to better cancer management, policymakers and oncologist should advocate the economic evaluation methods and modeling to select a real option in the treatment of patients to save resources like UK-ALL.