PMID- 36272529
OWN - NLM
STAT- MEDLINE
DCOM- 20230110
LR  - 20230207
IS  - 2666-6367 (Electronic)
IS  - 2666-6367 (Linking)
VI  - 29
IP  - 1
DP  - 2023 Jan
TI  - A Model to Estimate Cytokine Release Syndrome and Neurological Event Management 
      Costs Associated With CAR T-Cell Therapy.
PG  - 59.e1-59.e6
LID - S2666-6367(22)01704-3 [pii]
LID - 10.1016/j.jtct.2022.10.009 [doi]
AB  - Chimeric antigen receptor (CAR) T-cell therapies demonstrated efficacy in 
      relapsed/refractory large B-cell lymphoma (LBCL) but are associated with cytokine 
      release syndrome (CRS) and neurological events (NE). We wanted to estimate the 
      total cost of CRS and NE management among patients with relapsed/refractory LBCL 
      treated with lisocabtagene maraleucel (liso-cel), axicabtagene ciloleucel 
      (axi-cel), or tisagenlecleucel (tisa-cel) in the third- or later-line setting. An 
      economic decision tree model was developed using clinical and economic data to 
      estimate a weighted average per-patient adverse event (AE) management cost from a 
      United States health care system perspective in 2020 dollars. In 2 predefined 
      analyses, mean expected cost and 95% confidence intervals of the average treated 
      patient were estimated via Monte Carlo simulations, with per-patient costs for 
      each CAR T-cell therapy further stratified by AE and grade. In the base case, the 
      overall weighted average per-patient cost was $18,718, $47,665, and $42,538 for 
      liso-cel, axi-cel, and tisa-cel, respectively. The weighted average per-patient 
      cost per CRS event was $8213, $20,442, and $26,009 for liso-cel, axi-cel, and 
      tisa-cel, respectively; the weighted average per-patient cost per NE was $10,505, 
      $27,223, and $16,528, respectively. Differences in the base-case scenario 
      estimated total mean costs for liso-cel were -$28,947 and -$23,819 compared with 
      axi-cel and tisa-cel, respectively. In the scenario analysis (alternative cost 
      input), differences in the estimated total mean costs were -$24,498 for liso-cel 
      versus axi-cel, and -$19,326 for liso-cel versus tisa-cel. Across the base case 
      and scenario analysis, liso-cel had the lowest weighted average CRS and NE costs 
      per treated patient compared with axi-cel and tisa-cel owing to lower incidence 
      rates and symptom severity. These findings highlight the economic implications of 
      differences in safety among CAR T-cell therapies.
CI  - Copyright (c) 2022. Published by Elsevier Inc.
FAU - Badaracco, Jack
AU  - Badaracco J
AD  - BluePath Solutions, Los Angeles, California.
FAU - Gitlin, Matthew
AU  - Gitlin M
AD  - BluePath Solutions, Los Angeles, California.
FAU - Keating, Scott J
AU  - Keating SJ
AD  - Bristol Myers Squibb, Princeton, New Jersey. Electronic address: 
      scott.j.keating@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221019
PL  - United States
TA  - Transplant Cell Ther
JT  - Transplantation and cellular therapy
JID - 101774629
SB  - IM
MH  - Humans
MH  - *Immunotherapy, Adoptive/adverse effects
MH  - Cytokine Release Syndrome/etiology/therapy
MH  - *Lymphoma, Large B-Cell, Diffuse
MH  - Models, Economic
MH  - Monte Carlo Method
OTO - NOTNLM
OT  - Adverse events
OT  - CAR T
OT  - Cytokine release syndrome
OT  - Diffuse large B cell lymphoma
OT  - Health economics
OT  - Liso-cel
OT  - Neurological events
EDAT- 2022/10/23 06:00
MHDA- 2023/01/11 06:00
CRDT- 2022/10/22 19:24
PHST- 2022/06/14 00:00 [received]
PHST- 2022/09/27 00:00 [revised]
PHST- 2022/10/13 00:00 [accepted]
PHST- 2022/10/23 06:00 [pubmed]
PHST- 2023/01/11 06:00 [medline]
PHST- 2022/10/22 19:24 [entrez]
AID - S2666-6367(22)01704-3 [pii]
AID - 10.1016/j.jtct.2022.10.009 [doi]
PST - ppublish
SO  - Transplant Cell Ther. 2023 Jan;29(1):59.e1-59.e6. doi: 
      10.1016/j.jtct.2022.10.009. Epub 2022 Oct 19.