CLINICAL NEWS
benchmarks,” Ms. Saret
explained to ASH Clinical
News. “Cost-effectiveness
is one important input
that decision-makers
can use alongside other
factors such as side
effects, affordability,
overall budget impact,
and ethical and social
considerations.”
However, she pointed
out that her group’s analysis
did not examine “the question of affordability at the
patient level which is a related, but different, issue.”
Across the four cancer
types, the median ratio reported by industry-funded
studies ($26,000/QALY)
was lower (more favorable)
than the median reported
by non-industry-funded
studies ($33,000/QALY),
but these differences were
not statistically significant.
Median ratios fluctu-
ated across the time examined in their research:
• $35,000/QALY
(1996-2002)
• $52,000/QALY
(2003-2006)
• $22,000/QALY
(2007-2012)
The number of years a
treatment has been on
the market, differences in
therapy dose administration, and manufacturers’
pricing strategies were
cited as possible actors
on median ratio variability
across time.
“Given the increased
discussion about the high
cost of these treatments,
we were somewhat
surprised to discover that
their cost-effectiveness
ratios were lower than
expected,” senior study
author Peter S. Neumann, ScD, Director of the
Center for Evaluation of
Value and Risk in Health
at Tufts, told ASH Clinical
News. Although he noted
that the current study
had a small sample size
and cost-effectiveness
ratios may have changed
over time (as associated
costs or benefits have
also changed), “the study
underscores that debates
in health care should
consider the value of
breakthrough drugs, and
not just costs.”
Cost-effectiveness
studies may help
payers create more
knowledgeable coverage
policies, Ms. Saret added.
“These data may be used
as a component of the
decision-making process
when health insurance
MDS/MPN Overlap: The Time is
Now for Uniform Response Criteria
Myelodysplastic syndromes
(MDS)/myeloproliferative
neoplasms (MPNs) are clonal
myeloid disorders possessing
both dysplastic and proliferative
features that cannot be classified as one or the other – and for
which there are no standard adult
treatment recommendations. In
an effort to identify meaningful
clinical and biologic endpoints
to improve management and
disease outcomes, an international consortium has developed
a standardized response criteria
for clinical trials, according to a
report in Blood.
“We propose response assessment guidelines to harmonize
future clinical trials with the
principal objective of establishing
suitable treatment algorithms,”
wrote Michael Savona, MD, from
Vanderbilt University Medical
Center in Nashville, Tennessee,
and colleagues.
MDS/MPN, as characterized by
the World Health Organization,
include