Time-dependent cost comparison and health economic impact analysis of second-line interventions for transplant-ineligible patients with relapsed or refractory diffuse large B cell lymphoma.
Eur J Haematol
; 113(3): 371-383, 2024 Sep.
Article
em En
| MEDLINE
| ID: mdl-38853698
ABSTRACT
OBJECTIVES:
Novel interventions (axicabtagene ciloleucel [axi-cel], lisocabtagene maraleucel [liso-cel], tafasitamab-lenalidomide [Tafa-L], polatuzumab-rituximab-bendamustine [pola-BR]) improve clinical outcomes in second-line (2 L) treatment of transplant-ineligible patients with early relapse or refractory (R/R) diffuse large B cell lymphoma (DLBCL). The costs vary depending on the respective treatment regimen and the treatment duration, difficult comparability in reimbursement decisions. The objective was to analyze the health economic impacts of novel 2 L interventions and conventional immunochemotherapies (bendamustine-rituximab [BR], rituximab-gemcitabine-oxaliplatin [R-GemOx]) from a German healthcare payer's perspective as a function of treatment duration.METHODS:
An economic model was developed to compare treatment costs of 2 L interventions depending on the treatment duration. Treatment duration was measured by progression-free survival (PFS), identified based on a systematic review. Total and average costs were calculated over 5 years to evaluate incremental costs at median PFS for each intervention.RESULTS:
Average costs per month at median PFS ranged from 2846 (95% CI 5067-1641) to 40 535 (95% CI 91180-N/A) for BR and liso-cel, respectively. Incremental costs at the lowest median PFS (R-GemOx 5.3 months) revealed -664, 5560, 11 817, 53 145, and 67 745 for BR, Tafa-L, pola-BR, axi-cel, and liso-cel as compared to R-GemOx, respectively.CONCLUSIONS:
Analyses uncovered a variation of incremental costs of 2 L transplant-ineligible DLBCL interventions as a function of time leading to amortization of high-priced interventions.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Protocolos de Quimioterapia Combinada Antineoplásica
/
Linfoma Difuso de Grandes Células B
/
Análise Custo-Benefício
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article