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Pan-European multicentre economic evaluation of recombinant urate oxidase (rasburicase) in prevention and treatment of hyperuricaemia and tumour lysis syndrome in haematological cancer patients

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Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Goals

Hyperuricaemia (HU) and tumour lysis syndrome (TLS) are complications of acute myeloid/lymphoid leukaemia (AML/ALL) and non-Hodgkin lymphoma (NHL) leading to increased morbidity and mortality. The objective was to assess incremental cost-effectiveness ratios (ICER) of preventing/treating HU and TLS with recombinant urate oxidase, rasburicase (Fasturtec/Elitek).

Patients and methods

Incidence and costs of HU and TLS were based on a multi-country chart review. Life expectancy at the time of diagnosis was based on published survival rates and age at diagnosis. Reductions of HU/TLS following treatment with rasburicase were based on clinical trial data.

Results

Prevention with rasburicase appears highly cost-effective in children (ICER between €425 and €3054 per life-year saved, LYS). In adults, prevention is more cost-effective in NHL and ALL (maximum ICER of €41,383 and €32,126 per LYS). Treatment of established HU/TLS with rasburicase is cost-saving in children and highly cost-effective in adults. The results are robust in children. In adults, the prevention strategy appears sensitive to the risk of HU/TLS.

Conclusions

In conclusion, rasburicase, in addition to the demonstrated clinical benefit, is an economically attractive new option in the treatment of HU, both in adults and children. In prevention the drug has an attractive economic profile in children, and is cost-effective in adults with ALL and NHL.

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Acknowledgements

We would like to thank the staff of the following centres who participated in the retrospective chart review. Belgium: University Hospital Ghent, Department of Paediatric Haematology; UCL, University Hospital St Luc, Department of Paediatric Haematology, Woluwe; University Children's Hospital Brugman, Department of Paediatric Haematology, Jette; University Hospital Leuven, Department of Paediatric Haematology and Department of Haematology, Leuven; University Hospital UCL, Department of Haematology, Mont Godinne; Academic Hospital Middelheim, Department of Haematology, Antwerp. The Netherlands: Erasmus University Medical Centre, Sophia Children's Hospital, Department of Paediatric Oncology/Haematology, Rotterdam; Emma Children's Hospital AMC, Department of Paediatric Oncology, Amsterdam. UK: Sheffield Children's Hospital, Department of Paediatric Haematology, Sheffield; The Christie Hospital, Department of Medical Oncology, Manchester; Llandough Hospital, Department of Haematology, Penarth; Royal Bournemouth Hospital, Department of Haematology, Bournemouth. Spain: Hospital Clinico Universitario, Department of Oncology, Valencia; Sant Joan De Déu, Department of Paediatric Haematology, Espugues; Vall d'Hebron, Department of Paediatric Oncology, Barcelona; Marqués de Valdecilla, Department of Haematology, Santander.

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Authors and Affiliations

  1. HEDM (Health Economics and Disease Management), Brusselsesteenweg 91, 1860, Meise, Belgium

    L. Annemans, K. Moeremans & M. Lamotte

  2. Department of Public Health, Ghent University, De Pintelaan 185 blok A, 9000, Ghent, Belgium

    L. Annemans

  3. University Clinic Hospital, University of Valencia, Avda. Vicente Blasco Ibañez 17, 46010, Valencia, Spain

    J. Garcia Conde

  4. Emma Children Hospital AMC, University of Amsterdam, Amsterdam, The Netherlands

    H. van den Berg

  5. Royal Bournemouth Hospital, Castle Lane East, Bournemouth, BH7 7DW, UK

    H. Myint

  6. Erasmus Medical Centre, Sophia Childrens Hospital, Dr. Molewaterplein 60, 3015GJ, Rotterdam, The Netherlands

    R. Pieters

  7. University Hospital Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium

    A. Uyttebroeck

Authors
  1. L. Annemans
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  2. K. Moeremans
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  3. M. Lamotte
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  4. J. Garcia Conde
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  5. H. van den Berg
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  6. H. Myint
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  7. R. Pieters
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  8. A. Uyttebroeck
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Corresponding author

Correspondence to L. Annemans.

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Annemans, L., Moeremans, K., Lamotte, M. et al. Pan-European multicentre economic evaluation of recombinant urate oxidase (rasburicase) in prevention and treatment of hyperuricaemia and tumour lysis syndrome in haematological cancer patients. Support Care Cancer 11, 249–257 (2003). https://doi.org/10.1007/s00520-002-0435-3

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  • DOI: https://doi.org/10.1007/s00520-002-0435-3

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