Table 1.
Model and Cost a Parameters.
| Parameters | Model | Reference |
|---|---|---|
| Probabilities, % (unless otherwise stated) Probability of WW at diagnosis |
85.0 | Assumption, Chen [12] |
| Median time to first treatment (years) | 4.8 | Parikh [2] |
| Transition probability from WW to first treatment by cycle | 1.65 | Model calibration |
| Proportion of patients in IV therapy | 100.0 | When both formulas available |
| Prevalence of del(17p) | 7.0 | Hallek [5] |
| Proportion of mutated IGHV | 40.0 | Confirmed by KOL |
| Proportion of non-mutated IGHV | 60.0 | Confirmed by KOL |
| Mean age at diagnosis | 71 | LLSC [1] |
| Probability of age at diagnosis | ||
| Age <65 years old | 33.5 | Statistics Canada [9] |
| Age 65–70 years old b | 14.3 | Statistics Canada [9] |
| >70 years old | 52.3 | Statistics Canada [9] |
| Probability of fitness | ||
| Age <65 years old | 90.0 | Confirmed by KOL |
| Age 65–70 years old | 50.0 | Confirmed by KOL |
| >70 years old b | 0.0 | Confirmed by KOL |
| Probability of discontinuing OTT for each 4-week cycle | ||
| First-line treatment | 0.7 | Burger [13] |
| Relapsed patients | 1.4 | Burger [13] |
| Costs, $ | ||
| Laboratory monitoring costs | ||
| Electrolyte panel | 7.32 | Code L226, 204, 053,165,194,061 [14] |
| Renal panel | 2.56 | Code L251,067 [14] |
| Liver function tests | 10.39 | Code L223, 222, 191,029,030, 031, 005, 208 [14] |
| CBC panel | 3.98 | Code L393 [14] |
| Coagulation parameters | 6.20 | Code LG031 [14] |
| Serology | 10.25 | CodeL319 [14] |
| Chemotherapy infusion, administration and management |
105.15 | Schedule of benefits. Code G359. [15] |
| Professional fees | ||
| Consultation, hematology | 157.00 | Schedule of benefits. Code A615. [15] |
| Partial assessment hematology | 38.05 | Schedule of benefits. Code A618. [15] |
| Nurse average wage ($/min) | 0.61 | Job Bank Canada (NOC 3012). [16] |
| Pharmacist average wage ($/min) | 0.89 | Job Bank Canada (NOC 3131). [16] |
| Adverse events | ||
| Anemia | 4853 | OCCI code D649. [17] |
| Neutropenia | 7445 | OCCI code D70. [17] |
| Thrombocytopenia | 7572 | OCCI code D69.6. [17] |
| Infection (viral\bacterial unspecified) | 5802 | OCCI code A49.9\B34.9. [17] |
| Arterial fibrillation | 6546 | OCCI code I48.90. [17] |
CBC, complete blood count; del(17p), deletion at chromosome 17p targeting TP53 gene; IGHV, immunoglobulin heavy chain variable; IV, intravenous; KOL, key opinion Leader; LLSC, Leukemia and Lymphoma Society of Canada; OCCI, Ontario Care Costing Initiative; OTT, oral targeted therapy; WW, watchful waiting. a All costs are shown in 2019 Canadian dollars b Assumed that all patients older than 70 years old are unfit.