Authors' recommendations: The ERG found evidence that R-FC delays progression by 10 months (investigators’ assessment) compared to treatment with FC alone in patients who have previously received alkylator-containing chemotherapy or fludarabine alone, are fludarabine sensitive and are considered suitable for treatment with FC. There was no evidence from current data to show that R-FC prolongs survival compared to FC. With no survival benefit assumed in the economic model, the base-case ICER changes from £15,593 to between £40,000 and £42,000/QALY and becomes sensitive to changes in utility. Further modelling around a hypothetical survival benefit found that rituximab would be cost-effective at a threshold of around £20,000/QALY (£30,000/QALY) when a 40% (80%) reduction in survival benefit relative to the manufacturer’s base case was assumed. Further evidence is needed onwhether there is a survival benefit, the extent of this benefit and the associated utilities. Robust evidence is lacking on (a) the effectiveness of R-FC in patients who have previously received FC, R-FC or R-chemotherapy (other) as first-line therapy and (b) the effectiveness of R-chemotherapy (other) as treatment for relapsed CLL.

Project Status: Completed

URL for project: http://www.hta.ac.uk/erg/supplements/supplement1402.pdf#nameddest=article03

Year Published: 2010

URL for published report: http://www.hta.ac.uk/2052

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Health Technology Assessment programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk

Copyright: 2010 Queen's Printer and Controller of HMSO