Arsenic trioxide (ATO)-based regimens are the standard of care for treating acute promyelocytic leukaemia (APL) and have replaced chemotherapy-based approaches. However, the cost of "patented" ATO is prohibitive because of patent rights. "Generic" ATO has been used in a few countries, but its implications for health resource utilization (HRU) and cost of treatment are unknown. We hypothesized that treating APL patients using generic ATO (APL-ATO) will be cost effective compared to the chemotherapy-based regimen (APL-CT). In a single-centre retrospective study, we used a bottom-up costing method to compare the direct medical cost of treatment and HRU between APL-ATO and APL-CT. These costs and the survival and relapse probabilities were imputed in a three-state Markov decision model to estimate the cost effectiveness of APL-ATO compared to APL-CT. The mean cost of treatment for APL-ATO (n = 30, $8500 ± 2078) was significantly less than for APL-CT (n = 30, $22 600 ± 5528) (P < 0·001). APL-ATO reduced hospitalization, antibiotic and antifungal usage (P < 0·001). In the Markov model, five-year treatment costs were significantly lower for APL-ATO ($11 131) than for APL-CT ($17 926) (P < 0·001). Treatment cost and health resource utilization were significantly lower for generic ATO-treated APL patients compared to the chemotherapy-based regimen.

中文翻译：

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使用通用三氧化二砷治疗急性早幼粒细胞白血病的资源利用和成本效益。

基于三氧化二砷（ATO）的方案是治疗急性早幼粒细胞白血病（APL）的护理标准，并已取代基于化学疗法的方法。但是，由于专利权的原因，“获得专利的” ATO的成本过高。“通用” ATO已在一些国家使用，但其对卫生资源利用（HRU）和治疗费用的影响尚不清楚。我们假设与基于化学疗法的方案（APL-CT）相比，使用通用ATO（APL-ATO）治疗APL患者将具有成本效益。在单中心回顾性研究中，我们使用自下而上的成本核算方法来比较APL-ATO和APL-CT之间的直接医疗治疗费用和HRU。在三态马尔可夫决策模型中估算了这些成本以及生存率和复发率，以估算APL-ATO与APL-CT相比的成本效益。APL-ATO的平均治疗成本（n = 30，$ 8500±2078）显着低于APL-CT（n = 30，$ 22 600±5528）（P <0·001）。APL-ATO减少了住院，抗生素和抗真菌剂的使用（P <0·001）。在马尔可夫模型中，APL-ATO的五年治疗费用（11 131美元）明显低于APL-CT的五年治疗费用（17 926美元）（P <0·001）。与基于化学疗法的治疗方案相比，接受一般ATO治疗的APL患者的治疗费用和健康资源利用率显着降低。APL-ATO减少了住院，抗生素和抗真菌剂的使用（P <0·001）。在马尔可夫模型中，APL-ATO的五年治疗费用（11 131美元）显着低于APL-CT的五年治疗费用（17 926美元）（P <0·001）。与基于化学疗法的治疗方案相比，接受一般ATO治疗的APL患者的治疗费用和健康资源利用率显着降低。APL-ATO减少了住院，抗生素和抗真菌剂的使用（P <0·001）。在马尔可夫模型中，APL-ATO的五年治疗费用（11 131美元）显着低于APL-CT的五年治疗费用（17 926美元）（P <0·001）。与基于化学疗法的治疗方案相比，接受一般ATO治疗的APL患者的治疗费用和健康资源利用率显着降低。