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Cost Effectiveness of Imatinib Mesylate in the Treatment of Advanced Gastrointestinal Stromal Tumours

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Abstract

Background and objective: Imatinib mesylate is the first effective therapy for advanced unresectable gastrointestinal stromal tumours (GIST). Adoption of this therapy in clinical practice is partly dependent on reimbursement by third-party payers in many countries. The objective of this study was to estimate the cost effectiveness of imatinib mesylate in the treatment of GIST.

Methods: A cost-effectiveness model of GIST treatment was developed. Long-term survival and duration of imatinib mesylate benefit were projected by fitting curves to 52-month follow-up data from a phase II clinical trial of imatinib and projecting weekly probabilities of survival and continued treatment over 10 years. Weekly cost estimates in 2005 US dollars included cost of imatinib mesylate 400 mg/day ($US685), other medical services for imatinib mesylate-treated patients ($US359) and palliative care for patients in the end stage of GIST ($US2575). Utility associated with successful treatment was estimated at 0.935 and that of treatment failure and progressive disease at 0.875. Costs, life-years and quality-adjusted life-years (QALYs) were calculated over the 10-year time horizon and discounted to treatment initiation at an annual rate of 3%.

Results: Imatinib mesylate therapy for unresectable GIST was projected to increase life expectancy to 5.8 years, an increase of 2.7 years over the control group. This translated into an increase of 1.9 QALYs at a marginal cost of $US74 369, yielding a cost-effectiveness ratio of $US38 723 per QALY. Cost effectiveness was not very sensitive to model parameters other than the cost of imatinib mesylate itself.

Conclusion: The cost effectiveness of imatinib mesylate in the treatment of GIST is within the commonly accepted range for life-saving interventions, based on US data.

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Acknowledgements

Funding for this study was provided by Novartis Pharmaceuticals, Florham Park, New Jersey, USA. Dr Feng is an employee of Novartis Pharmaceuticals. The other authors have no conflicts of interest that are directly relevant to the content of this study.

The authors are grateful to the reviewers for their valuable comments.

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Authors and Affiliations

  1. Thomson Medstat, 150 Cambridgepark Drive, Cambridge, Massachusetts, 02140, USA

    Daniel M. Huse & Gregory Lenhart

  2. Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA

    Margaret von Mehren

  3. Department of Oncology, Helsinki University, Helsinki University Central Hospital, Helsinki, Finland

    Heikki Joensuu

  4. The Oregon Health and Science University Cancer Institute, Portland, Oregon, USA

    Charles Blanke

  5. Novartis Pharmaceuticals Corporation, Oncology, Florham Park, New Jersey, USA

    Weiwei Feng

  6. MIT Sloan School of Management, Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, USA

    Stan Finkelstein

  7. Dana-Farber Cancer Institute, Center for Sarcoma and Bone Oncology, Boston, Massachusetts, USA

    George Demetri

Authors
  1. Daniel M. Huse
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  2. Margaret von Mehren
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  3. Gregory Lenhart
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  4. Heikki Joensuu
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  5. Charles Blanke
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  6. Weiwei Feng
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  7. Stan Finkelstein
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  8. George Demetri
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Correspondence to Daniel M. Huse.

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Huse, D.M., von Mehren, M., Lenhart, G. et al. Cost Effectiveness of Imatinib Mesylate in the Treatment of Advanced Gastrointestinal Stromal Tumours. Clin. Drug Investig. 27, 85–93 (2007). https://doi.org/10.2165/00044011-200727020-00001

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