Economic evaluation of treatment for acute lymphoblastic leukaemia in childhood

Area of Science:

• Pediatric Oncology
• Health Economics
• Quality of Life Research

Background:

• Widely adopted treatment protocols for pediatric acute lymphoblastic leukemia (ALL) include the Berlin-Frankfurt-Munster (BFM) and Dana-Farber Cancer Institute (DFCI) strategies.
• Comparative analyses of these leading pediatric ALL treatment protocols are essential for informing clinical and economic decision-making.

Purpose of the Study:

• To compare the health effects and associated monetary costs of hospital treatments between the BFM and DFCI strategies for childhood ALL.
• To evaluate the cost-effectiveness and quality-adjusted life years (QALYs) associated with BFM versus DFCI treatment protocols in pediatric ALL patients.

Main Methods:

• Health-related quality of life (HRQL) assessments were conducted on children undergoing BFM or DFCI treatment across multiple international centers.
• QALYs were calculated based on HRQL scores over a 5-year period post-diagnosis.
• Treatment costs were determined using administrative database variables within a publicly funded healthcare system.

Main Results:

• No statistically significant difference was observed in QALYs between patients treated with BFM (<1.0% greater) and DFCI strategies.
• Mean total treatment costs for BFM (US$88,480) and DFCI (US$93,026) were not significantly different (P=0.600).
• HRQL scores indicated comparable outcomes between the two treatment protocols.

Conclusions:

• This study found no evidence to support the superiority of either the BFM or DFCI treatment strategy for childhood ALL in terms of health effects or economic costs.
• Both BFM and DFCI strategies should be considered standard care for future economic evaluations of pediatric ALL treatments.
• Further research may explore long-term outcomes and patient-reported experiences beyond the 5-year evaluation period.