Cost-Effectiveness of Duvelisib Versus the Bendamustine Plus Rituximab Regimen for Relapsed/Refractory Follicular Lymphoma Patients in China

OBJECTIVES: To assess the cost-effectiveness of duvelisib compared to the bendamustine plus rituximab (BR) regimen for treating adult patients with relapsed/refractory follicular lymphoma (RR FL) who have undergone at least two lines of prior therapy in Chinese healthcare setting.

METHODS: The analysis was based on a partitioned survival model that estimated quality-adjusted life years (QALYs), direct medical costs, and incremental cost-effectiveness ratios (ICERs). The efficacy and safety data of the drug were sourced from Phase II clinical trial data of the Chinese population. Drug costs, other direct medical expenses, and utility value data were obtained from electronic records or literature databases. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) were used to test the robustness of the model.

RESULTS: The model was run for 10 years for adult patients with RR FL who have undergone at least two prior lines of therapy. Duvelisib was found to be a more expensive treatment option than the BR regimen, with total costs of ¥614,333 ($89,201.15) and ¥454,527 ($65,997.32), respectively. However, duvelisib was also associated with a greater number of QALYs gained (4.23 vs. 2.73 for BR), resulting in an ICER of ¥106,894 ($15,521.01) per QALY gained. The results of the one-way sensitivity analysis indicated that the proportion of patients who continued using duvelisib after disease progression, the rate at which costs are discounted, and the cost of subsequent use of duvelisib after disease progression were the three most influential factors. The PSA result showed that at a willingness-to-pay threshold of three times the GDP per capita, the probability that duvelisib was cost-effective compared to the BR regimen was 75.74%.

CONCLUSIONS: From the perspective of Chinese national healthcare system, we conclude that compared to the BR regimen, duvelisib is a cost-effective option for adult patients with RR FL who have received at least two prior lines of therapy.