The Cost-Effectiveness of Allogeneic Stem Cell Transplantation Among Patients With Myelofibrosis
Key Takeaways:
- Among patients with high-risk myelofibrosis (MF), Janus kinase (JAK) inhibitors cost significantly more than allogeneic stem cell transplantation (allo-SCT), with an upfront total cost of $889 009 compared to $681 583-$733 676.
- Allo-SCT and JAK inhibitors were associated with similar health outcomes, as allo-SCT resulted in 2.70-2.72 quality-adjusted life years (QALYs) gained, and JAK inhibitors yielded 2.97 QALYs gained.
- The study’s findings indicate allo-SCT as a more cost-effective treatment option for patients with MF as opposed to JAK inhibitor therapy.
Treatment optimization for MF requires a careful balance of clinical efficacy against associated risks. Allo-SCT, while effective, is associated with adverse events such as infection, bleeding, and graft-versus-host disease (GVHD). JAK inhibitor therapy presents an alternative option for MF treatment, but research remains limited.
Researchers conducted a cost-effective analysis of allo-SCT against JAK inhibitor therapy among patients with high-risk MF who are eligible for transplantation.
Study Methods and Outcomes
Using data from published clinical trials and large cohort studies, investigators developed a 5-year decision analytic model that assessed transplant outcomes, chronic GVHD occurrence and duration, non-relapse mortality, JAK inhibitor response and progression, and secondary acute myeloid leukemia (AML) transformation.
The study’s primary outcomes included life years (LYS), QALYs, total costs, and incremental cost-effectiveness ratios (ICERs).
Allo-SCT vs JAK Inhibitor Therapy
JAK inhibitor therapy accumulated significantly higher total costs than allo-SCT, $889 009 vs $681 583-$733 676, respectively. These costs are largely influenced by drug costs, indicating that allo-SCT may be more cost-effective than JAK inhibitors.
Both therapies resulted in comparable health outcomes. JAK inhibitors resulted in 2.97 QALYs, slightly higher than allo-SCT's QALYs of 2.70-2.72.
At a willingness-to-pay threshold of $150 000, the resulting ICER was significantly higher at $577 807-$809 880.
Implications for Oncology Care
These findings demonstrate the cost-effectiveness of allo-SCT compared to JAK inhibitor therapy, as it is associated with similar patient outcomes at significantly lower costs.
The authors said, “More data are needed to define outcomes after multiple JAK inhibitor failures. Additionally, future therapies that reduce transformation risk could shift the comparative value of medical therapy.”
Reference
Huang L, Chang S, Oh S. A cost-effectiveness analysis of JAK inhibitor therapy versus allogeneic stem cell transplantation in myelofibrosis. J Clin Oncol. 2026;44(16):e18606. doi:10.1200/JCO.2026.44.16_suppl.e18606
