Societal Impact Valuation of Axicabtagene Ciloleucel in Diffuse B-Cell Lymphoma in the Netherlands

OBJECTIVES: Impacts of innovative therapies are commonly assessed using cost/QALY and budget-impact frameworks from a healthcare payer perspective. Such approaches ignore the totality of value a therapy may bring to society. This study therefore estimates the broader societal impact of axicabtagene ciloleucel (axi-cel) in diffuse large B-cell lymphoma (DLBCL) in the Netherlands.

METHODS: Value and Balancing Alliance methodology is used to estimate the broader societal impact of axi-cel based on three dimensions: social, macroeconomic, and environmental impact. Social impact consists of 1) direct paid effects; 2) indirect paid effects; and 3) unpaid effects. These are estimated based on the QALYs gained for a new therapy vs. standard of care (SOC) and the additional extent to which a person can return to work (paid or unpaid) after treatment. The macroeconomic and environmental impacts for the Netherlands are then calculated for axi-cel using the Kite/Gilead’s gross domestic product contribution and a natural capital accounting per impact driver (carbon emission, water consumption, waste and product packaging) for axi-cel’s net zero production respectively.

RESULTS: Here we present preliminary results of the incremental direct paid effects. These represent one-third of the social impact of treating a DLBCL patient with axi-cel vs. SOC. The estimates are based on the QALYs gained (1,63 for 2L DLBCL and 5,29 for 3L+ DLBCL) and estimated in monetary values as €102.053 for 2L DLBCL and €274.954 for 3L+ DLBCL. The remaining two-thirds of social impact (indirect paid and unpaid effects), and monetized estimates of the macroeconomic and environmental impacts will be added to determine the overall broader societal impact of axi-cel.

CONCLUSIONS: Estimation of the broader societal impact of an innovative therapy, like axi-cel in DLBCL, contributes to a comprehensive representation of its true overall value. This type of assessment is required to completely understand the value innovative therapies, like axi-cel, provide to society.