Cost-utility analysis of blinatumomab in pediatric patients with acute lymphoblastic leukemia in Iran.

BACKGROUND AND OBJECTIVE: This study aimed to evaluate the cost-utility analyses of blinatumomab in children with relapsed/refractory B-cell Acute Lymphoblastic Leukemia (B-ALL) compared to Consolidation Chemotherapy in Iran. METHOD: Based on the results of the phase III randomized 20120215 trial (NCT02393859) the cost-utility analysis, was evaluated over a lifetime using the Parietal Survival model with three health states. The model considered both direct and indirect costs from a societal perspective. The incremental cost-effectiveness ratio (ICER) was calculated by determining the cost per quality-adjusted life year (QALY) gained. Costs and QALYs were discounted annually at 5.8% and 5%, respectively. Deterministic sensitivity analysis (DSA) and Probabilistic sensitivity analysis (PSA) were performed to assess the model's robustness. RESULTS: The study estimated that blinatumomab is a cost-effective treatment option, with a probability of 57.2%. Blinatumomab was associated with a higher cost ($42,481 versus $21,355) and higher QALYs gained (13.14 versus 8.06) compared to Consolidation Chemotherapy with an ICER of USD 4,160, which is below the willingness-to-pay (WTP) threshold of 4,210 USD in Iran. CONCLUSIONS: Blinatumomab is a cost-effective treatment strategy for pediatric patients with relapsed/refractory B-cell acute lymphoblastic leukemia B-ALL from an Iranian societal perspective.