278P - A systematic literature review of the cost-effectiveness of treatments, costs, and resource use in patients with Burkitt lymphoma

Abstract

BackgroundBurkitt Lymphoma (BL) is a rare and aggressive type of non-Hodgkin lymphoma (NHL), accounting for 0.8% of all B-cell lymphomas, with five-year survival ranging from 48% to 87%. Currently, intensive short-cycle and low-intensity multiagent immunochemotherapy regimens are used, however, it is not clear what health economic evidence exists for treatments in BL. Thereby, a systematic literature review (SLR) was conducted to understand the economic (costs and resource-use, economic evaluations) evidence base for patients with BL. MethodsAn SLR was conducted using Embase®, PubMed®, and EconLit from database inception through June 2019. ResultsA total of 758 abstracts and 132 full-texts were screened. We identified 2 economic evaluations and 7 studies reporting data for costs or resource-use covering four countries (Malawi, Nigeria, Uganda, Netherlands). The economic evidence varied in different regions due to unbalanced socio-economic development. The median length of hospital stay ranged from 13 days in Nigeria to 134 days in the Netherlands. The patients were also reluctant to healthcare and took 4-8 weeks from the onset of symptoms to present at the treatment centers in Nigeria. The total direct cost of treating BL was US$103.8 (Nigeria), US$350.14 (Uganda), and US$7342.17 (Netherlands) per patient. Dominant drivers for cost were the length of in-hospital stay and medication costs. Both the economic evaluations presented models for paediatric patients with no treatment as the comparator of choice and a continuous discount rate of 3%. Models were built from a governmental perspective with discounting and duration of treatment significantly impacting the sensitivity analysis. The cost per DALY averted was US$97 in Uganda and US$14,243 in Malawi, reflecting very cost-effective chemotherapeutic interventions. ConclusionsThis review highlights the limited literature on the economic dimensions of BL treatment, however, also demonstrates cost-effective interventions in resource-limited settings. There remains a need for future research and careful consideration of BL as an investment in health systems strengthening and improving the health outcomes. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.