The cost-effectiveness of idarubicin/cytosine arabinoside versus daunorubicin/cytosine arabinoside in the treatment of adults with acute myeloid leukemia.

The cost-effectiveness of two chemotherapeutic regimens was evaluated from the results of a randomized clinical trial involving patients with previously untreated acute myeloid leukemia. The evaluable subjects were 120 patients with acute myeloid leukemia randomly assigned to receive 12 mg/m2 of idarubicin (IDA) or 50 mg/m2 of daunorubicin (DNR) daily for three days. The patients also received 200 mg/m2 of cytosine arabinoside daily for five days, with an additional 25-mg/m2 bolus on the first day of treatment, the patients underwent a second course at the same doses. The total hospital charges per patient were $59,687 for IDA treatment and $59,567 for DNR treatment; however, the cost per complete remission was lower in the IDA than in the DNR patients ($74,609 vs $102,115). The lower remission rate in the DNR-treated patients, and thus their need for additional care, will increase the cost differences between the two treatments. The hospital charges per year of survival were $36,395 for IDA treatment and $52,714 for DNR treatment. It is concluded that IDA is more cost-effective than DNR in the treatment of adult acute myeloid leukemia.