Cost-effectiveness of chimeric antigen receptor T-cell therapy in adults with relapsed or refractory follicular lymphoma

• DOI: 10.1182/bloodadvances.2022008097
• Publication Date: 2022-11-07T18:05:11Z
• Authors: Kunal C. Potnis; Mengyang Di; Iris Isufi; Lohith Gowda; Stuart E. Seropian; Francine M. Foss; Howard P. Forman; Scott F. Huntington
• Keywords: Follicular lymphoma; Refractory (planetary science); Cell therapy

Abstract Follicular lymphoma (FL) is traditionally considered treatable but incurable. In March 2021, the US Food and Drug Administration approved use of chimeric antigen receptor (CAR) T-cell therapy in patients with relapsed or refractory (R/R) FL after ≥2 lines therapy. Priced at $373 000, CAR potentially curative, its cost-effectiveness compared other modern R/R treatment strategies unknown. We developed a Markov model to assess third-line vs standard care (SOC) therapies adults FL. estimated progression rates for receiving SOC from ZUMA-5 trial LEO CReWE study, respectively. calculated costs, discounted life years, quality-adjusted years (QALYs), incremental ratio (ICER) willingness-to-pay threshold $150 000 per QALY. Our analysis was conducted payer’s perspective over lifetime horizon. our base-case model, cost strategy $731 682 $458 490 therapies. However, associated clinical benefit 1.50 QALYs, resulting an ICER $182 127 most sensitive utilities remission total upfront cost. Under current pricing, unlikely be cost-effective unselected setting. Both randomized trials longer term follow-up can help clarify benefits optimal sequencing