Cost, clinical variables, probabilities, and utilities (United Kingdom health care system model)
| Model variable . | Upfront HSCT . | Delayed HSCT . | Reference . | ||
|---|---|---|---|---|---|
| Base-case scenario . | Distribution used in PSAs . | Base-case scenario . | Distribution used in PSAs . | ||
| Primary treatment | |||||
| Cost of HSCT for the first 2 y∗ | £78 800 ($97 700) | Gamma (100, 977.30) | N/A | N/A | 17 |
| Probability of cGVHD after 2 y | 0.42 | Beta-PERT (0.34, 0.50) | N/A | N/A | 26 |
| Annual supportive care after 2 years from HSCT without cGVHD | £11 800 ($14 700) | Gamma (100, 146.64) | N/A | N/A | 16 |
| Annual supportive care after 2 years from HSCT with cGVHD | £24 200 ($30 000) | Gamma (100, 299.90) | N/A | N/A | 16 |
| Cost of CCT∗ | N/A | N/A | £11 700 ($14 500) | Gamma (100, 144.58) | 15 |
| Cost of 1 cycle of HiDAC before HSCT∗ | £2900 ($3600) | Gamma (100, 36.14) | N/A | N/A | 15 |
| Probability of HiDAC before HSCT∗ | 0.16 | Beta-PERT (0.13, 0.19) | N/A | N/A | 6 |
| Supportive care during CCT | N/A | N/A | £7000 ($8700) | (100, 86.65) | 15 |
| Annual supportive care for CCT after 6 months | N/A | N/A | £3900 ($4800) | Gamma (100, 47.98) | 15 |
| Salvage treatments | |||||
| Overall probability of HSCT after relapse† | 0.342 | N/A | 1 | Beta-PERT (0.8, 1) | 19 |
| Probability of only HSCT after relapse† | 0.0513 | Beta-PERT (0.04, 0.06) | 0.49 0.0513‡ | Beta-PERT (0.39, 0.59) Beta-PERT (0.04, 0.06)† | 6,19 |
| Cost of HIC plus HSCT after relapse∗ | £126 400 ($156 700) | NA | £126 400 ($156 700) | NA | 17,39 |
| Probability of HIC plus HSCT after relapse† | 0.2907 | Beta-PERT (0.23, 0.35) | 0.43 0.2907‡ | Beta-PERT (0.34, 0.51) Beta-PERT (0.23, 0.35)† | 6,19 |
| Cost of LIC plus HSCT after relapse∗ | £115 500 ($143 200) | NA | £115 500 ($143 200) | NA | 17,39 |
| Probability of LIC plus HSCT after relapse† | 0 | N/A | 0.08 0‡ | Beta-PERT (0.07, 0.1) N/A | 6,19 |
| Cost of HIC only after relapse∗ | £47 500 ($59 000) | Gamma (100, 589.58) | £47 500 ($59 000) | Gamma (100, 589.58) | 39 |
| Probability of HIC only after relapse† | 0.23 | Beta-PERT (0.18, 0.28) | 0 0.23‡ | N/A Beta-PERT (0.18, 0.28)∗ | 6,19 |
| Cost of LIC only after relapse∗ | £36 700 ($45 500) | Gamma (100, 454.94) | £36 700 ($45 500) | Gamma (100, 454.94) | 39 |
| Probability of LIC only after relapse† | 0.3 | Beta-PERT (0.24, 0.36) | 0 0.3‡ | N/A Beta-PERT (0.24, 0.36)∗ | 6,19 |
| Cost of BSC only after relapse∗ | £4700 ($5800) | Gamma (100, 57.92) | £4700 ($5800) | Gamma (100, 57.92) | 39 |
| Probability of BSC only after relapse† | 0.128 | Beta-PERT (0.03, 0.045) | 0 0.128‡ | N/A Beta-PERT (0.11, 0.17)∗ | 6,19 |
| Cost of supportive care | |||||
| Cost of terminal care | £16 700 ($20 700) | Gamma (100, 206.79) | £16 700 ($20 700) | Gamma (100, 206.79) | 15 |
| GVHD | |||||
| Probability of cGVHD after 2 y | 0.42 | Beta-PERT (0.34, 0.50) | N/A | N/A | 26 |
| Survival parameter | |||||
| HR OS | 1.74 (1.39-2.09) | N/A | Ref | N/A | 6 |
| HR DFS | 0.45 (0.36-0.54) | N/A | Ref | N/A | 6 |
| Utilities | |||||
| During CCT | N/A | N/A | 0.58 | Beta-PERT (0.464, 0.696) | 27 |
| After CCT | N/A | N/A | 0.85 | Beta-PERT (0.688, 1) | 27 |
| During HSCT | 0.613 | Beta-PERT (0.49, 0.736) | 0.597 | Beta-PERT (0.478, 0.716) | 26 |
| After 6 months from HSCT until 1 y | 0.81 | Beta-PERT (0.648, 0.972) | 0.81 | Beta-PERT (0.648, 0.972) | 26 |
| Relapse | 0.53 | Beta-PERT (0.424, 0.636) | 0.53 | Beta-PERT (0.424, 0.636) | 26 |
| Model variable . | Upfront HSCT . | Delayed HSCT . | Reference . | ||
|---|---|---|---|---|---|
| Base-case scenario . | Distribution used in PSAs . | Base-case scenario . | Distribution used in PSAs . | ||
| Primary treatment | |||||
| Cost of HSCT for the first 2 y∗ | £78 800 ($97 700) | Gamma (100, 977.30) | N/A | N/A | 17 |
| Probability of cGVHD after 2 y | 0.42 | Beta-PERT (0.34, 0.50) | N/A | N/A | 26 |
| Annual supportive care after 2 years from HSCT without cGVHD | £11 800 ($14 700) | Gamma (100, 146.64) | N/A | N/A | 16 |
| Annual supportive care after 2 years from HSCT with cGVHD | £24 200 ($30 000) | Gamma (100, 299.90) | N/A | N/A | 16 |
| Cost of CCT∗ | N/A | N/A | £11 700 ($14 500) | Gamma (100, 144.58) | 15 |
| Cost of 1 cycle of HiDAC before HSCT∗ | £2900 ($3600) | Gamma (100, 36.14) | N/A | N/A | 15 |
| Probability of HiDAC before HSCT∗ | 0.16 | Beta-PERT (0.13, 0.19) | N/A | N/A | 6 |
| Supportive care during CCT | N/A | N/A | £7000 ($8700) | (100, 86.65) | 15 |
| Annual supportive care for CCT after 6 months | N/A | N/A | £3900 ($4800) | Gamma (100, 47.98) | 15 |
| Salvage treatments | |||||
| Overall probability of HSCT after relapse† | 0.342 | N/A | 1 | Beta-PERT (0.8, 1) | 19 |
| Probability of only HSCT after relapse† | 0.0513 | Beta-PERT (0.04, 0.06) | 0.49 0.0513‡ | Beta-PERT (0.39, 0.59) Beta-PERT (0.04, 0.06)† | 6,19 |
| Cost of HIC plus HSCT after relapse∗ | £126 400 ($156 700) | NA | £126 400 ($156 700) | NA | 17,39 |
| Probability of HIC plus HSCT after relapse† | 0.2907 | Beta-PERT (0.23, 0.35) | 0.43 0.2907‡ | Beta-PERT (0.34, 0.51) Beta-PERT (0.23, 0.35)† | 6,19 |
| Cost of LIC plus HSCT after relapse∗ | £115 500 ($143 200) | NA | £115 500 ($143 200) | NA | 17,39 |
| Probability of LIC plus HSCT after relapse† | 0 | N/A | 0.08 0‡ | Beta-PERT (0.07, 0.1) N/A | 6,19 |
| Cost of HIC only after relapse∗ | £47 500 ($59 000) | Gamma (100, 589.58) | £47 500 ($59 000) | Gamma (100, 589.58) | 39 |
| Probability of HIC only after relapse† | 0.23 | Beta-PERT (0.18, 0.28) | 0 0.23‡ | N/A Beta-PERT (0.18, 0.28)∗ | 6,19 |
| Cost of LIC only after relapse∗ | £36 700 ($45 500) | Gamma (100, 454.94) | £36 700 ($45 500) | Gamma (100, 454.94) | 39 |
| Probability of LIC only after relapse† | 0.3 | Beta-PERT (0.24, 0.36) | 0 0.3‡ | N/A Beta-PERT (0.24, 0.36)∗ | 6,19 |
| Cost of BSC only after relapse∗ | £4700 ($5800) | Gamma (100, 57.92) | £4700 ($5800) | Gamma (100, 57.92) | 39 |
| Probability of BSC only after relapse† | 0.128 | Beta-PERT (0.03, 0.045) | 0 0.128‡ | N/A Beta-PERT (0.11, 0.17)∗ | 6,19 |
| Cost of supportive care | |||||
| Cost of terminal care | £16 700 ($20 700) | Gamma (100, 206.79) | £16 700 ($20 700) | Gamma (100, 206.79) | 15 |
| GVHD | |||||
| Probability of cGVHD after 2 y | 0.42 | Beta-PERT (0.34, 0.50) | N/A | N/A | 26 |
| Survival parameter | |||||
| HR OS | 1.74 (1.39-2.09) | N/A | Ref | N/A | 6 |
| HR DFS | 0.45 (0.36-0.54) | N/A | Ref | N/A | 6 |
| Utilities | |||||
| During CCT | N/A | N/A | 0.58 | Beta-PERT (0.464, 0.696) | 27 |
| After CCT | N/A | N/A | 0.85 | Beta-PERT (0.688, 1) | 27 |
| During HSCT | 0.613 | Beta-PERT (0.49, 0.736) | 0.597 | Beta-PERT (0.478, 0.716) | 26 |
| After 6 months from HSCT until 1 y | 0.81 | Beta-PERT (0.648, 0.972) | 0.81 | Beta-PERT (0.648, 0.972) | 26 |
| Relapse | 0.53 | Beta-PERT (0.424, 0.636) | 0.53 | Beta-PERT (0.424, 0.636) | 26 |
HIC, high-intensity chemotherapy (cytarabine in combination with daunorubicin, doxorubicin, etoposide, idarubicin, mitoxantrone, cladribine, or clofarabine); HiDAC, high-dose cytarabine; LIC, low-intensity chemotherapy (monotherapy of azacitidine, cytarabine, decitabine, gemtuzumab, glasdegib, and ivosidenib).
Adjusted for inflation until the end of 2022.
Calculated depending on data derived from the original trial and literature variables.
This value is a secondary value from the literature for probability of patients who did not undergo salvage HSCT as documented in the ETAL-1 trail.