Economic analysis of adjuvant therapy with interferon alpha-2a in stage II malignant melanoma

Abstract 

Using the trial demonstrating that interferonα-2a (IFNα-2a) is efficacious as adjuvant therapy in stage II melanoma, we evaluate its outcomes and economic consequences. Using rates observed in the 5-year trial and published figures, survival and Q-TWIST (Time Without Symptoms and Toxicity) were extrapolated to a 10-year and lifetime horizon. Cost analysis was performed using the trial's data, published literature and experts' opinions from the perspective of the French Sickness Funds. Patients in the IFNα-2a-group have an additional 0.26 years in life-expectancy over a 5-year time period (P=0.046), 0.67 years over a 10-year period and 2.59 years over a lifetime. Cost per life-year-gained was estimated at approximately 14 400 after 5 years, 6635 after 10 years and 1716 over a lifetime. Assuming that there is an improvement in disease-free survival only, cost is 26 147 per Q-TWIST. Cost-effectiveness of IFNα-2a in stage II melanoma compares favourably with estimates for widely used therapies in the oncological field.

Keywords:  Cost-benefit analysis, Melanoma, Quality of life, Neoplasm recurrence, Interferon alpha-2a

• 1 French cooperative group on melanoma: P. de la Salmonière, D. Cupissol, B. Guillot, P. Souteyrand, B. Sassolas, J.P. Cesarini, S. Lionnet, C. Lok, C. Chastang, E. Mansat, J.P. Lacour, L Thomas, M. Beylot Barry, J.F. Truchelet, P. Chemaly, L. Machet, J. Meynadier, A. Thyss, M.F. Avril, C. Vilmer, F. Prigent, J. Chevrant Breton, S. Dalac, P. Fargeot, P. Amblard, R. Schaerrer, M. Geniaux, M. Caubel, G. Guillet, M. Baccard, J.C. Guillaume, C. Pauwels, JC. Barats, P. Wolkenstein, L. Cals, R. Laurent, C. Beylot, G. Lorette, J.P. Denoeux, I. Masson, P. Royer, M. Masson.