COST-EFFECTIVENESS OF IBRUTINIB-VENETOCLAX VERSUS IBRUTINIB MONOTHERAPY FOR RELAPSED OR REFRACTORY MANTLE CELL LYMPHOMA FROM CHINESE AND US HEALTHCARE PERSPECTIVES...
Author(s)
Hongyu Yan1, yunjie su, postgraduate2.
1nanjing, China, 2nanjing medical university, Nanjing, China.
1nanjing, China, 2nanjing medical university, Nanjing, China.
OBJECTIVES: OBJECTIVES To conduct the first cost-effectiveness analysis of ibrutinib-venetoclax versus ibrutinib monotherapy for relapsed or refractory (R/R) mantle cell lymphoma (MCL) from Chinese healthcare system and US payer perspectives, and to inform reimbursement policy in two distinct pricing environments.
METHODS: METHODS A partitioned survival model with three health states (progression-free, progressed disease, and death) was constructed over a lifetime horizon using individual patient-level data reconstructed from Kaplan-Meier curves published in the SYMPATICO phase 3 trial. Costs and outcomes were discounted annually at 5% (China) and 3% (US). Willingness-to-pay (WTP) thresholds were set at US$40,457/QALY (China) and US$100,000-150,000/QALY (US). One-way deterministic sensitivity analyses, probabilistic sensitivity analyses (5,000 Monte Carlo simulations), scenario analyses, TP53-mutated subgroup analyses, and venetoclax price threshold analyses were performed.
RESULTS: RESULTS In China, ibrutinib-venetoclax yielded 0.42 incremental QALYs at an incremental cost of US$6,198, producing an ICER of US$14,664/QALY—well below the Chinese WTP threshold. In the US, 0.48 incremental QALYs were achieved at an incremental cost of US$153,550, yielding an ICER of US$319,987/QALY, exceeding both US WTP thresholds. Probabilistic sensitivity analysis confirmed approximately 100% and 0% cost-effectiveness probabilities in China and the US, respectively. In TP53-mutated patients, ICERs improved markedly to US$9,437/QALY (China) and US$165,769/QALY (US). US threshold analysis indicated venetoclax pricing would need to decrease to US$62.50/100 mg for the ICER to reach US$150,000/QALY.
CONCLUSIONS: CONCLUSIONS Ibrutinib-venetoclax is cost-effective for R/R MCL in China at current National Reimbursement Drug List prices but not in the US. Future NRDL coverage of venetoclax for the MCL indication could further improve the economic profile in China. TP53-mutated patients represent a clinically and economically compelling subgroup warranting prioritized reimbursement consideration in both settings.
METHODS: METHODS A partitioned survival model with three health states (progression-free, progressed disease, and death) was constructed over a lifetime horizon using individual patient-level data reconstructed from Kaplan-Meier curves published in the SYMPATICO phase 3 trial. Costs and outcomes were discounted annually at 5% (China) and 3% (US). Willingness-to-pay (WTP) thresholds were set at US$40,457/QALY (China) and US$100,000-150,000/QALY (US). One-way deterministic sensitivity analyses, probabilistic sensitivity analyses (5,000 Monte Carlo simulations), scenario analyses, TP53-mutated subgroup analyses, and venetoclax price threshold analyses were performed.
RESULTS: RESULTS In China, ibrutinib-venetoclax yielded 0.42 incremental QALYs at an incremental cost of US$6,198, producing an ICER of US$14,664/QALY—well below the Chinese WTP threshold. In the US, 0.48 incremental QALYs were achieved at an incremental cost of US$153,550, yielding an ICER of US$319,987/QALY, exceeding both US WTP thresholds. Probabilistic sensitivity analysis confirmed approximately 100% and 0% cost-effectiveness probabilities in China and the US, respectively. In TP53-mutated patients, ICERs improved markedly to US$9,437/QALY (China) and US$165,769/QALY (US). US threshold analysis indicated venetoclax pricing would need to decrease to US$62.50/100 mg for the ICER to reach US$150,000/QALY.
CONCLUSIONS: CONCLUSIONS Ibrutinib-venetoclax is cost-effective for R/R MCL in China at current National Reimbursement Drug List prices but not in the US. Future NRDL coverage of venetoclax for the MCL indication could further improve the economic profile in China. TP53-mutated patients represent a clinically and economically compelling subgroup warranting prioritized reimbursement consideration in both settings.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE13
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology