PMID- 35844002
OWN - NLM
STAT- MEDLINE
DCOM- 20220811
LR  - 20230904
IS  - 1179-2027 (Electronic)
IS  - 1170-7690 (Linking)
VI  - 40
IP  - 9
DP  - 2022 Sep
TI  - The Cost Effectiveness of Axicabtagene Ciloleucel Versus Best Supportive Care in 
      the Treatment of Adult Patients with Relapsed or Refractory Large B-Cell Lymphoma 
      (LBCL) After Two or More Lines of Systemic Therapy in Canada.
PG  - 917-928
LID - 10.1007/s40273-022-01169-z [doi]
AB  - BACKGROUND AND OBJECTIVE: Axicabtagene ciloleucel (axi-cel) received marketing 
      authorisation in Canada for the treatment of relapsed or refractory large B-cell 
      lymphoma after two or more lines of systemic therapy, and the clinical and 
      economic value of axi-cel to patients and the healthcare system should be 
      examined. The objective of this analysis is to determine, from societal and 
      public healthcare payer perspectives, the cost effectiveness of axi-cel versus 
      best supportive care for patients with relapsed or refractory large B-cell 
      lymphoma in Canada. METHODS: A pharmacoeconomic model was developed and populated 
      with clinical data derived from the ZUMA-1 and SCHOLAR-1 studies using a 
      propensity score-matched comparison. A partitioned survival mixture-cure 
      modelling approach was taken to characterise the potential curative effect of 
      axi-cel therapy in large B-cell lymphoma. Healthcare resource utilisation and 
      adverse event data were based on results from ZUMA-1, and utility values were 
      derived from ZUMA-1 data supplemented with published literature. Costs (in 2021 
      Canadian dollars) were taken from publicly available Canadian cost databases and 
      published literature. Benefits and costs were discounted at 1.5% per year, and 
      sensitivity analyses were conducted to assess the robustness of the results. 
      RESULTS: In the base case, axi-cel generated an incremental 6.2 life-years 
      compared to best supportive care, corresponding to 4.6 additional 
      quality-adjusted life-years, and was associated with $606,010 in additional 
      costs. The incremental cost-utility ratio was $132,747 per quality-adjusted 
      life-year gained compared with best supportive care from a societal perspective 
      ($106,392 per quality-adjusted life-year gained from a public healthcare payer 
      perspective). Key drivers of the analysis included progression-free survival and 
      overall survival values for axi-cel. CONCLUSIONS: The results of this analysis 
      suggest that axi-cel may be considered a cost-effective allocation of resources 
      compared with best supportive care for the treatment of adult patients with 
      relapsed or refractory large B-cell lymphoma in Canada.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
FAU - Hillis, Christopher
AU  - Hillis C
AD  - McMaster University, Hamilton, ON, Canada. hillisc@mcmaster.ca.
FAU - Vicente, Colin
AU  - Vicente C
AUID- ORCID: 0000-0002-2940-1743
AD  - PIVINA Consulting Inc., Mississauga, ON, Canada.
FAU - Ball, Graeme
AU  - Ball G
AD  - Gilead Sciences Canada Inc., Mississauga, ON, Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220718
PL  - New Zealand
TA  - Pharmacoeconomics
JT  - PharmacoEconomics
JID - 9212404
RN  - 0 (Antigens, CD19)
RN  - 0 (Biological Products)
RN  - U2I8T43Y7R (axicabtagene ciloleucel)
MH  - Adult
MH  - Antigens, CD19/adverse effects
MH  - *Biological Products/therapeutic use
MH  - Canada
MH  - Cost-Benefit Analysis
MH  - Humans
MH  - *Lymphoma, Large B-Cell, Diffuse/drug therapy
EDAT- 2022/07/18 06:00
MHDA- 2022/08/12 06:00
CRDT- 2022/07/17 23:18
PHST- 2022/06/20 00:00 [accepted]
PHST- 2022/07/18 06:00 [pubmed]
PHST- 2022/08/12 06:00 [medline]
PHST- 2022/07/17 23:18 [entrez]
AID - 10.1007/s40273-022-01169-z [pii]
AID - 10.1007/s40273-022-01169-z [doi]
PST - ppublish
SO  - Pharmacoeconomics. 2022 Sep;40(9):917-928. doi: 10.1007/s40273-022-01169-z. Epub 
      2022 Jul 18.