Objectives: To determine cost-effectiveness of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) compared with R-CHOP (CHOP plus Rituximab) in adult patients with diffuse large B-cell lymphoma, in a Greek Academic Hospital. Patients and methods: The control group consisted of 65 consecutive patients, observed from 1992 to 1999 and received CHOP chemotherapy. The study group consisted of 44 consecutive patients, observed from 2006 to 2011 and received R-CHOP chemotherapy. Overall survival and direct medical cost were estimated for both interventions. Clinical data from Coiffier study were used to calculate Incremental Cost-Effectiveness Ratio per life years gained (LYGs) and life years gained free from progression disease (PFYs).
Results: Overall survival rose from 50% to 72% after 5 years with the addition of Rituximab to CHOP therapy. Total cost of R-CHOP treatment was calculated at and j23,882 and at j6,909 for CHOP. Incremental cost- effectiveness ratio formatted at j3,394 for R-CHOP and j1,381 for CHOP per LYG and at j3,935 for R-CHOP and j12,470 for CHOP per PFY, with 5 and 3.6 years survival benefit in favor of R-CHOP, retrospectively. Conclusion: Even though Rituximab increases total, direct cost of treatment, cost effectiveness analysis indicates that R-CHOP is clinically and economically effective.
Keywords: CHOP, cost-effectiveness analyses, diffuse large B-cell lymphoma, health economics, non- Hodgkin’s lymphoma, rituximab.