The cost-effectiveness of personalized medicine strategies in acute myeloid leukemia

Abstract

Cancer is one of the most important health problems in the developing world with an estimated incidence of 3.5 million per year and 1.75 million deaths in Europe in 2012. Thereby cancer attributes to about 28% of all deaths and is the second leading cause of death in Europe. Although cancer is one of the most important causes of death nowadays, survival after cancer has been improved over time. The improvements in survival are caused by earlier detection of cancer and new treatment developments. The earlier detection enables a more adequate treatment with higher chances of cure. However, the earlier detection can also artificially improve survival as the time to death will increase if the diagnosis has been set earlier. The new treatment options include new technologies and pharmaceuticals. Due to the large incidence of cancer and the high costs of the new technologies and pharmaceuticals to treat cancer, the economic burden of cancer is substantial. The high mortality and morbidity of cancer also poses a large burden on society in terms of productivity loss and informal care costs. It is expected that the costs of cancer will increase in the future. This increase will be partly caused by an increase in cancer incidence due to the aging of the population as cancer occurs more frequently in older patients. Furthermore, new developments in diagnosis and treating cancer are often associated with high costs. A balance needs to be found between the reduction in mortality and morbidity and the rising health care costs due to the new technologies. One of the new technology developments in the field of cancer is personalized medicine. Personalized medicine is a term that is used for medicine which is targeted to a specific patient group. The main reasons for the development of personalized medicine is that a one-size-fits-all treatment approach does not always lead to the most desirable outcomes as not all patients respond to the treatment. Response rates of cancer drugs approved 1995 and 2005 ranged between 10 and 80% . Currently, new techniques enable a better identification of responders and non-responders before the start of the treatment. If treatment will be restricted to the responders only, the effectiveness of the treatment will increase. Furthermore, the costs might decrease as fewer patients receive the expensive treatment and fewer side-effects are experienced because nonresponders are no longer exposed to an ineffective and possible toxic treatment.