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Cost-Effectiveness Analysis Of The Prevention And Treatment Of Cytomegalovirus (CMV) Infections After Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) In Adults

Toni Vekov, Anna Gavrilova, Nadia Veleva, Jivko Kolev


The aim of the study was to model the local data on the costs and health benefits of alternative antiviral therapies for the prevention and treatment of CMV seropositive patients after HSCT and to perform an indirect comparison based on meta-analysis. Input data in the model are the measured and evaluated clinical endpoints in the randomized multicentre clinical trial MK-8228-001. The modeling of the data for future health benefits and costs after the end of the clinical trials was conducted using a Markov model with 6 health conditions and 1 absorbent state. The model includes all possible health conditions reflecting the course of the disease and all the probabilities of transition from one health condition to another are envisaged. Input data in the model are the primary and secondary endpoints in the randomized clinical trial MK-8228-001 - clinically significant CMV infection at weeks 12 and 24, preemptive therapy for CMV viremia and CMV-related terminal organ diseases.

The time horizon of the model is lifelong. Costs and benefits are discounted at 5% per annum. The perspective chosen is the point of view of the third party payer. The conclusion of the evaluations is that letermovir dominates valganciclovir with improved therapeutic efficacy and lower cost of treatment for cytomegalovirus-seropositive patients after allogeneic hematopoietic stem cell transplantation.


cost-effectiveness analysis, cytomegalovirus/seropositive patients/allogeneic hematopoietic stem cell transplantation, alternative antiviral therapies

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