PMID- 37250912
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230918
IS  - 2040-6207 (Print)
IS  - 2040-6215 (Electronic)
IS  - 2040-6207 (Linking)
VI  - 14
DP  - 2023
TI  - Cost-effectiveness analysis of axicabtagene ciloleucel as a second-line treatment 
      for diffuse large B-cell lymphoma in China and the United States.
PG  - 20406207231168215
LID - 10.1177/20406207231168215 [doi]
LID - 20406207231168215
AB  - BACKGROUND: Axicabtagene ciloleucel (Axi-cel) is the first Chimeric Antigen 
      Receptor T-Cell Immunotherapy (CAR-T) product approved in China for treating 
      adult patients with relapsed or refractory large B-cell lymphoma after receiving 
      second-line or above systemic therapy. However, it cannot be widely used in 
      clinical practice due to its high price. OBJECTIVES: To evaluate the economic 
      value of Axi-cel fully in countries at different stages of economic development, 
      this article, from the perspective of the medical and health system in China and 
      the United States, evaluated the cost-effectiveness of Axi-cel in the second-line 
      treatment of diffuse large B-cell lymphoma (DLBCL). DESIGN: Cost effectiveness 
      analysis of Axi-cel in the treatment of relapsed or refractory large B-cell 
      lymphoma (LBCL). METHODS: Based on the clinical trial data of ZUMA-7, a 
      short-term decision tree and a long-term semi-Markov partitioned survival model 
      were constructed to evaluate the cost-effectiveness of the two strategies. This 
      model was cycled for 40 years in 1-month cycles. In this article, only direct 
      medical costs were considered. One-way sensitivity analysis and probabilistic 
      sensitivity analysis were conducted to assess the robustness of the base-case 
      results. RESULTS: In the baseline cost-effectiveness analysis, Axi-cel was 
      associated with more quality-adjusted life year (QALY; 2.72 versus 1.46) and 
      greater costs overall ($180,501.55 versus $123,221.34) than standard second-line 
      chemotherapy in China. Moreover, the incremental cost-effectiveness ratio (ICER) 
      of the Axi-cel group was $45,726.66/QALY, which was greater than the threshold of 
      $37,654.5. To achieve cost-effectiveness, the price of Axi-cel must be reduced 
      appropriately. In the United States, Axi-cel was associated with more QALYs (2.63 
      versus 1.74) and greater costs overall ($415,915.16 versus $289,564.34). The ICER 
      for the Axi-cel was $142,326.94/QALY, below the set threshold of $150,000. 
      CONCLUSION: Axi-cel is not a cost-effective option as second-line therapy for 
      treating DLBCL in China. However, In the United States, Axi-cel has shown a 
      cost-effectiveness advantage as a second-line treatment for DLBCL.
CI  - (c) The Author(s), 2023.
FAU - Li, Na
AU  - Li N
AUID- ORCID: 0000-0002-5529-0127
AD  - Fujian Medical University Union Hospital, Fuzhou, China.
AD  - The School of Pharmacy, Fujian Medical University, Fuzhou, China.
FAU - Lei, Jianying
AU  - Lei J
AD  - Fujian Medical University Union Hospital, Fuzhou, China.
AD  - The School of Pharmacy, Fujian Medical University, Fuzhou, China.
FAU - Zhang, Jiahao
AU  - Zhang J
AD  - Fujian Medical University Union Hospital, Fuzhou, China.
AD  - The School of Pharmacy, Fujian Medical University, Fuzhou, China.
FAU - Cai, Hongfu
AU  - Cai H
AD  - Fujian Medical University Union Hospital, Fuzhou, China.
AD  - The School of Pharmacy, Fujian Medical University, Fuzhou, China.
FAU - Zheng, Bin
AU  - Zheng B
AD  - Fujian Medical University Union Hospital, Fuzhou, China.
AD  - The School of Pharmacy, Fujian Medical University, Fuzhou, China.
FAU - Yang, Ting
AU  - Yang T
AD  - Fujian Medical University Union Hospital, Fuzhou, China.
FAU - Liu, Maobai
AU  - Liu M
AD  - Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou 350001, 
      China.
AD  - The School of Pharmacy, Fujian Medical University, Fuzhou, China.
FAU - Hu, Jianda
AU  - Hu J
AD  - Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou 350001, 
      China.
AD  - The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
LA  - eng
PT  - Journal Article
DEP - 20230523
PL  - England
TA  - Ther Adv Hematol
JT  - Therapeutic advances in hematology
JID - 101549589
PMC - PMC10214081
OTO - NOTNLM
OT  - Markov model
OT  - axicabtagene ciloleucel
OT  - cost-effectiveness
OT  - large B-cell lymphoma
OT  - second-line treatment
COIS- The authors declared no potential conflicts of interest with respect to the 
      research, authorship, and/or publication of this article.
EDAT- 2023/05/30 13:07
MHDA- 2023/05/30 13:08
PMCR- 2023/05/23
CRDT- 2023/05/30 11:30
PHST- 2022/11/11 00:00 [received]
PHST- 2023/03/21 00:00 [accepted]
PHST- 2023/05/30 13:07 [pubmed]
PHST- 2023/05/30 13:08 [medline]
PHST- 2023/05/30 11:30 [entrez]
PHST- 2023/05/23 00:00 [pmc-release]
AID - 10.1177_20406207231168215 [pii]
AID - 10.1177/20406207231168215 [doi]
PST - epublish
SO  - Ther Adv Hematol. 2023 May 23;14:20406207231168215. doi: 
      10.1177/20406207231168215. eCollection 2023.