PMID- 32397772
OWN - NLM
STAT- MEDLINE
DCOM- 20210629
LR  - 20210629
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 23
IP  - 9
DP  - 2020 Sep
TI  - Estimation of total costs in patients with relapsed or refractory diffuse large 
      B-cell lymphoma receiving tisagenlecleucel from a US hospital's perspective.
PG  - 1016-1024
LID - 10.1080/13696998.2020.1769109 [doi]
AB  - Aims: This study estimated the total costs associated with tisagenlecleucel 
      treatment in adult patients with relapsed/refractory (r/r) diffuse large B-cell 
      lymphoma (DLBCL) based on the JULIET trial from a United States hospital's 
      perspective.Methods: An economic model was developed to assess the total costs 
      associated with tisagenlecleucel treatment (from leukapheresis to two months 
      post-infusion) in adults (aged >/=18 years) with r/r DLBCL using a fee-for-service 
      approach. Costs were considered during the pre-treatment, tisagenlecleucel 
      infusion, and follow-up periods, and were estimated based on the health resource 
      utilization and safety data from the JULIET trial. Cost components included 
      leukapheresis, lymphodepleting chemotherapy, tisagenlecleucel 
      infusion/administration, inpatient and intensive care unit (ICU) admission, 
      medical professional visits, lab tests/procedures, and management of adverse 
      events (AEs). The base-case model estimated the total costs using observed 
      hospitalization, ICU, and AE data from JULIET, while scenario analyses varied key 
      assumptions related to AEs and hospitalization.Results: The estimated overall 
      cost associated with tisagenlecleucel treatment from leukapheresis to two months 
      post-infusion was $437,927/patient, of which $64,784 (14.8%) was additional to 
      tisagenlecleucel's list price ($373,000) and the associated administration cost 
      ($143). The top three key drivers of the additional cost were AE management 
      ($30,594; 47.2%), inpatient/ICU not attributed to AEs ($24,285; 37.5%), and lab 
      tests/procedures ($5,443; 8.4%). In the scenario analyses, total costs ranged 
      from $382,702 (no AEs, no hospitalization) to $469,006 (cytokine release syndrome 
      and B-cell aplasia, hospitalization).Limitations: This analysis was limited to 
      two months of follow-up after tisagenlecleucel infusion, which cannot capture 
      long-term safety outcomes associated with the treatment and may underestimate AE 
      costs.Conclusions: The total cost of tisagenlecleucel administration from 
      leukapheresis to two months was estimated at $437,927. In addition to 
      tisagenlecleucel's price, the main drivers were AE management costs and 
      inpatient/ICU costs. Future studies based on real-world, long-term use of 
      tisagenlecleucel are warranted.
FAU - Yang, Hongbo
AU  - Yang H
AD  - Analysis Group, Inc., Boston, MA, USA.
FAU - Hao, Yanni
AU  - Hao Y
AD  - Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
FAU - Chai, Xinglei
AU  - Chai X
AD  - Analysis Group, Inc., Boston, MA, USA.
FAU - Qi, Cynthia Z
AU  - Qi CZ
AD  - Analysis Group, Inc., Boston, MA, USA.
FAU - Wu, Eric Q
AU  - Wu EQ
AD  - Analysis Group, Inc., Boston, MA, USA.
LA  - eng
PT  - Journal Article
DEP - 20200602
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
RN  - 0 (Receptors, Antigen, T-Cell)
RN  - 0 (Receptors, Chimeric Antigen)
RN  - Q6C9WHR03O (tisagenlecleucel)
SB  - IM
MH  - Cost-Benefit Analysis
MH  - Health Expenditures/statistics & numerical data
MH  - Health Resources/economics
MH  - Humans
MH  - Immunotherapy, Adoptive/adverse effects/*economics/*methods
MH  - Lymphoma, Large B-Cell, Diffuse/*drug therapy
MH  - Models, Economic
MH  - Receptors, Antigen, T-Cell/administration & dosage/*therapeutic use
MH  - Receptors, Chimeric Antigen
MH  - United States
OTO - NOTNLM
OT  - Chimeric antigen receptor T-cell therapy
OT  - I11
OT  - I12
OT  - costs
OT  - diffuse large B-cell lymphoma
OT  - health resource use
OT  - tisagenlecleucel
EDAT- 2020/05/14 06:00
MHDA- 2021/06/30 06:00
CRDT- 2020/05/14 06:00
PHST- 2020/05/14 06:00 [pubmed]
PHST- 2021/06/30 06:00 [medline]
PHST- 2020/05/14 06:00 [entrez]
AID - 10.1080/13696998.2020.1769109 [doi]
PST - ppublish
SO  - J Med Econ. 2020 Sep;23(9):1016-1024. doi: 10.1080/13696998.2020.1769109. Epub 
      2020 Jun 2.