PMID- 38240256
OWN - NLM
STAT- MEDLINE
DCOM- 20240214
LR  - 20240214
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 27
IP  - 1
DP  - 2024 Jan-Dec
TI  - Cost-effectiveness of axicabtagene ciloleucel versus tisagenlecleucel for the 
      treatment of 3L + relapsed/refractory large B-cell lymphoma in the United States: 
      incorporating longer survival results.
PG  - 230-239
LID - 10.1080/13696998.2024.2305558 [doi]
AB  - AIMS: To provide an update on the cost-effectiveness of the chimeric antigen 
      receptor (CAR) T-cell therapies axicabtagene ciloleucel (axi-cel) and 
      tisagenlecleucel (tisa-cel) for the treatment of relapsed/refractory (r/r) large 
      B-cell lymphoma (LBCL) among patients who have previously received >/=2 lines of 
      systemic therapy using more mature clinical trial data cuts (60 months for 
      axi-cel overall survival [OS] and 45 months for tisa-cel OS and progression-free 
      survival [PFS]). METHODS: A partitioned survival model consisting of three health 
      states (pre-progression, post-progression and death) was used to estimate 
      quality-adjusted life years (QALYs) and costs associated with axi-cel and 
      tisa-cel over a lifetime horizon. PFS and OS inputs for axi-cel and tisa-cel were 
      based on a previously published matching-adjusted indirect treatment comparison 
      (MAIC). Long-term OS and PFS were extrapolated using parametric survival mixture 
      cure models (PS-MCMs). Costs of CAR-T cell therapy drug acquisition and 
      administration, conditioning chemotherapy, apheresis, CAR T-specific monitoring, 
      stem cell transplant, hospitalization, adverse events, routine care, and terminal 
      care were sourced from US cost databases. Health state utilities were derived 
      from previous publications. Model inputs were varied using a range of sensitivity 
      and scenario analyses. RESULTS: Compared with tisa-cel, axi-cel resulted in 2.51 
      additional QALYs and $50,185 additional costs (an incremental cost-effectiveness 
      ratio [ICER] of $19,994 per QALY gained). In probabilistic sensitivity analysis 
      (PSA), the ICER for axi-cel versus tisa-cel was </=$50,000/QALY in 99.4% of 
      simulations and </=$33,500 in 99% of simulations. Axi-cel remained cost-effective 
      versus tisa-cel (assuming a willingness-to-pay threshold of $150,000 per QALY) 
      across a range of scenarios. CONCLUSIONS: With longer-term survival data, axi-cel 
      continues to represent a cost-effective option versus tisa-cel for treatment of 
      r/r LBCL among patients who have previously received >/=2 lines of systemic 
      therapy, from a US payer perspective.
FAU - Oluwole, Olalekan O
AU  - Oluwole OO
AUID- ORCID: 0000-0001-8525-9641
AD  - Vanderbilt University Medical Center, Nashville, TN, USA.
FAU - Ray, Markqayne D
AU  - Ray MD
AD  - Kite, A Gilead Company, Santa Monica, CA, USA.
FAU - Davies, Neil
AU  - Davies N
AD  - Mtech Access, Cheadle Hulme, UK.
FAU - Bradford, Rory
AU  - Bradford R
AD  - Mtech Access, Cheadle Hulme, UK.
FAU - Jones, Calum
AU  - Jones C
AD  - Mtech Access, Cheadle Hulme, UK.
FAU - Patel, Anik R
AU  - Patel AR
AD  - Kite, A Gilead Company, Santa Monica, CA, USA.
FAU - Locke, Frederick L
AU  - Locke FL
AUID- ORCID: 0000-0001-9063-6691
AD  - H. Lee Moffitt Cancer Center, Tampa, FL, USA.
LA  - eng
PT  - Journal Article
DEP - 20240213
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
RN  - Q6C9WHR03O (tisagenlecleucel)
RN  - U2I8T43Y7R (axicabtagene ciloleucel)
RN  - 0 (Biological Products)
RN  - 0 (Receptors, Antigen, T-Cell)
SB  - IM
MH  - Humans
MH  - United States
MH  - Cost-Benefit Analysis
MH  - *Lymphoma, Large B-Cell, Diffuse/therapy
MH  - *Biological Products
MH  - *Receptors, Antigen, T-Cell
OTO - NOTNLM
OT  - C
OT  - C01
OT  - Cost-effectiveness
OT  - I
OT  - I1
OT  - I10
OT  - O
OT  - O5
OT  - O51
OT  - anti-CD19
OT  - axicabtagene ciloleucel (axi-cel)
OT  - chimeric antigen receptor, T-cell therapy
OT  - iCER
OT  - large B-cell lymphoma
OT  - matching-adjusted indirect comparison
OT  - tisagenlecleucel (tisa-cel)
EDAT- 2024/01/19 12:44
MHDA- 2024/02/14 12:45
CRDT- 2024/01/19 08:14
PHST- 2024/02/14 12:45 [medline]
PHST- 2024/01/19 12:44 [pubmed]
PHST- 2024/01/19 08:14 [entrez]
AID - 10.1080/13696998.2024.2305558 [doi]
PST - ppublish
SO  - J Med Econ. 2024 Jan-Dec;27(1):230-239. doi: 10.1080/13696998.2024.2305558. Epub 
      2024 Feb 13.