Electronic Thesis and Dissertation Repository

Degree

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Greg Zaric

Abstract

We conducted a cost-effectiveness analysis of brentuximab vedotin for the treatment of relapsed and refractory Hodgkin Lymphoma (HL) from health care system perspective in Canada. We developed a Markov decision analytical model to simulate lifetime costs and benefits and parameterized the model using brentuximab phase II clinical trial and cd-link data which is a linked datasets of cancer registry with administrative databases of Ontario, Canada. In the base case scenario, brentuximab treatment led to an increase of 0.352 Quality Adjusted Life Years (QALYs) per person and $108,500 per person, which resulted in incremental cost effectiveness ratio (ICER) of $308,532 per QALYs gained. The ICER was sensitive to hazard ratio, cost per dose of brentuximab and utility values. In conclusion, brentuximab has an ICER higher than $100,000 per QALY threshold that is often classified as having “weak evidence for adoption and appropriate utilization” in Canada according best available information so far. The substantial reduction (e.g., 72%) in the cost of unit dose of brentuximab can reduce ICER dramatically and make the drug cost effective.

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