FUNCTIONAL PRECISION MEDICINE TESTING IMPROVED THE CLINICAL OUTCOME OF NON-HODGKIN LYMPHOMA PATIENTS WITH ACCEPTABLE COST-EFFECTIVENESS...
Author(s)
Weng Tong Ho, PhD1, William Wee Lee Chan, MD2, Yi Ching Yuen, MClinPharm3, Rui Xue Lee, PhD4, Michelle Limei Poon, MD2, Sanjay de Mel, MD2, Anand D Jeyasekharan, MD4, Andreas Voss, MD1, Edward Chow, PhD1.
1KYAN Technologies Pte Ltd, Singapore, Singapore, 2Department of Haematology-Oncology, National University Health System, Singapore, Singapore, 3Department of Pharmacy, National University Health System, Singapore, Singapore, 4Cancer Science Institute of Singapore, Singapore, Singapore.
1KYAN Technologies Pte Ltd, Singapore, Singapore, 2Department of Haematology-Oncology, National University Health System, Singapore, Singapore, 3Department of Pharmacy, National University Health System, Singapore, Singapore, 4Cancer Science Institute of Singapore, Singapore, Singapore.
OBJECTIVES: Functional Precision Medicine, including ex-vivo drug sensitivity testing to guide cancer treatment, is an emerging approach with promising clinical utility and treatment decision support, particularly in multiple relapsed/refractory cancers and patients without standard of care. This analysis evaluated whether Optim.AITM, a combinatory drug sensitivity test, is cost-effective in guiding treatments of relapsed/refractory non-Hodgkin lymphoma (r/r NHL).
METHODS: Survival data of Optim.AITM-guided treatment was extracted from a previously reported clinical utility study. A partitioned survival framework was used to estimate time in PFS and PD. Drug costs were based on the institutional physician guide cost. Utility values were obtained from published hematologic malignancy cost-effectiveness studies (PFS: 0.79; PD: 0.54). QALY and ICERs were assessed against the willingness-to-pay (WTP) threshold of SGD75, 000 previously reported.
RESULTS: Optim.AITM-guided treatment improved mean OS (354.4 vs 296.4 days) and PFS (234.7 vs 151.5 days) in the study population. In the primary analysis evaluating Optim.AITM cost alone, the incremental gain was 52.5 QALD, and the ICER was SGD38,264/QALY, well below the predefined WTP threshold. When treatment costs were included, incremental cost increased to SGD17,710, and ICER increased to SGD 123, 215/QALY, due to greater use of novel agents with restricted access in Singapore, like Romidepsin in Optim.AITM arm. We demonstrated higher PFS when the use of romidepsin was Optim.AITM-guided empirical prescription (median PFS 190 vs 70 days). In heavily pretreated patients (> 2 prior lines), Optim.AITM yielded greater benefit (incremental gain: 126.4 QALD) with an ICER of SGD 44, 376/QALY than in the whole study population.
CONCLUSIONS: Optim.AI™-guided treatment is cost-effective versus physician-guided treatment in r/r NHL. ICER estimates indicate particular benefit after failure of well proven standard of care therapies. Treatment costs strongly influence the cost effectiveness and the clinical benefit from high-priced novel drug Romidepsin could be maximized using OptimAITM.
METHODS: Survival data of Optim.AITM-guided treatment was extracted from a previously reported clinical utility study. A partitioned survival framework was used to estimate time in PFS and PD. Drug costs were based on the institutional physician guide cost. Utility values were obtained from published hematologic malignancy cost-effectiveness studies (PFS: 0.79; PD: 0.54). QALY and ICERs were assessed against the willingness-to-pay (WTP) threshold of SGD75, 000 previously reported.
RESULTS: Optim.AITM-guided treatment improved mean OS (354.4 vs 296.4 days) and PFS (234.7 vs 151.5 days) in the study population. In the primary analysis evaluating Optim.AITM cost alone, the incremental gain was 52.5 QALD, and the ICER was SGD38,264/QALY, well below the predefined WTP threshold. When treatment costs were included, incremental cost increased to SGD17,710, and ICER increased to SGD 123, 215/QALY, due to greater use of novel agents with restricted access in Singapore, like Romidepsin in Optim.AITM arm. We demonstrated higher PFS when the use of romidepsin was Optim.AITM-guided empirical prescription (median PFS 190 vs 70 days). In heavily pretreated patients (> 2 prior lines), Optim.AITM yielded greater benefit (incremental gain: 126.4 QALD) with an ICER of SGD 44, 376/QALY than in the whole study population.
CONCLUSIONS: Optim.AI™-guided treatment is cost-effective versus physician-guided treatment in r/r NHL. ICER estimates indicate particular benefit after failure of well proven standard of care therapies. Treatment costs strongly influence the cost effectiveness and the clinical benefit from high-priced novel drug Romidepsin could be maximized using OptimAITM.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE109
Topic
Economic Evaluation
Disease
SDC: Oncology, STA: Personalized & Precision Medicine