PMID- 37544410
OWN - NLM
STAT- MEDLINE
DCOM- 20231109
LR  - 20231109
IS  - 2666-6367 (Electronic)
IS  - 2666-6367 (Linking)
VI  - 29
IP  - 11
DP  - 2023 Nov
TI  - Estimating the Cost per Clinical Outcome of Second-Line Liso-Cel Versus 
      Autologous Stem Cell Transplantation in Patients with Transplantation-Intended 
      Relapsed/Refractory Large B Cell Lymphoma.
PG  - 712.e1-712.e7
LID - S2666-6367(23)01437-9 [pii]
LID - 10.1016/j.jtct.2023.08.001 [doi]
AB  - It is important to consider the total cost of care (TCOC) associated with a 
      therapy and clinical benefit for relapsed or refractory (R/R) large B cell 
      lymphoma (LBCL). We estimated the 1-year TCOC and cost per clinical outcome for 
      patients with R/R LBCL treated with second-line lisocabtagene maraleucel 
      (liso-cel) versus autologous stem cell transplantation (ASCT) using data from the 
      TRANSFORM study (ClinicalTrials.gov NCT03575351). A cost per clinical outcome 
      analysis using a Monte Carlo simulation approach was conducted. Cost inputs were 
      generated from a retrospective microcosting analysis of healthcare resource 
      utilization (HCRU). Patient-level data from an interim analysis (March 2021) were 
      used to derive HCRU and clinical inputs. Clinical inputs included median 
      event-free survival (EFS), median progression-free survival (PFS), objective 
      response rate, and complete response (CR) rate. In the intention-to-treat 
      analysis, the mean (standard deviation) TCOC per patient was $550,864 ($173,087) 
      for liso-cel and $413,200 ($290,802) for ASCT. The cost per clinical outcome 
      model estimated a mean cost for liso-cel versus ASCT per EFS month of $57,295 
      versus $186,369, per PFS month of $40,949 versus $78,797, per overall responder 
      of $653,965 versus $881,804, and per complete responder of $828,045 versus 
      $1,063,822. This economic model shows reductions in mean estimated TCOC per EFS 
      month, PFS month, overall responder, and complete responder with liso-cel versus 
      ASCT owing to the superior efficacy of liso-cel. Although liso-cel-treated 
      patients incurred greater upfront costs, fewer required subsequent therapy, and 
      they accumulated less downstream costs. These results underscore the importance 
      of considering the durability of response and clinical benefit when assessing 
      total costs.
CI  - Copyright (c) 2023. Published by Elsevier Inc.
FAU - Saeedian, Matia
AU  - Saeedian M
AD  - BluePath Solutions, Los Angeles, California.
FAU - Badaracco, Jack
AU  - Badaracco J
AD  - BluePath Solutions, Los Angeles, California.
FAU - Botros, Afraim
AU  - Botros A
AD  - Bristol Myers Squibb, Princeton, New Jersey. Electronic address: 
      afraim.botros@bms.com.
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.
LA  - eng
SI  - ClinicalTrials.gov/NCT03575351
PT  - Journal Article
DEP - 20230805
PL  - United States
TA  - Transplant Cell Ther
JT  - Transplantation and cellular therapy
JID - 101774629
SB  - IM
MH  - Humans
MH  - *Hematopoietic Stem Cell Transplantation/methods
MH  - *Lymphoma, Large B-Cell, Diffuse/therapy
MH  - Remission Induction
MH  - Retrospective Studies
MH  - Transplantation, Autologous
MH  - Clinical Studies as Topic
OTO - NOTNLM
OT  - ASCT
OT  - CAR T
OT  - Cost per Outcome
OT  - LBCL
OT  - Microcosting
OT  - Total Cost of Care
EDAT- 2023/08/07 00:42
MHDA- 2023/11/03 06:44
CRDT- 2023/08/06 19:14
PHST- 2023/05/11 00:00 [received]
PHST- 2023/07/10 00:00 [revised]
PHST- 2023/08/01 00:00 [accepted]
PHST- 2023/11/03 06:44 [medline]
PHST- 2023/08/07 00:42 [pubmed]
PHST- 2023/08/06 19:14 [entrez]
AID - S2666-6367(23)01437-9 [pii]
AID - 10.1016/j.jtct.2023.08.001 [doi]
PST - ppublish
SO  - Transplant Cell Ther. 2023 Nov;29(11):712.e1-712.e7. doi: 
      10.1016/j.jtct.2023.08.001. Epub 2023 Aug 5.