A Systematic Review on Economic Evaluations of Comparisons Between CAR-T Therapies in Relapsed or Refractory Diffuse Large B-Cell Lymphoma
Author(s)
Tien Hoang Tran, MPH, RPh, PharmD, John Kim, BS, MS;
University of Maryland Baltimore, Practice, Sciences, and Health Outcomes Research, Baltimore, MD, USA
University of Maryland Baltimore, Practice, Sciences, and Health Outcomes Research, Baltimore, MD, USA
Presentation Documents
OBJECTIVES: CAR-T therapies may provide significant value to patients with relapsed or refractory diffuse large B-cell lymphoma (r/r DLBCL). While prior studies have compared them to standard of care, their value relative to other available CAR-T therapies is still unclear. This study reviews current evidence on economic evaluations comparing CAR-T therapies to each other for r/r DLBCL.
METHODS: We conducted a systematic review of economic evaluation studies that compared CAR-T therapies to each other for r/r DLBCL. Studies published up to December 31st, 2024 were identified using PubMed, Embase, and Scopus and reviewed by two independent reviewers. Those meeting the inclusion criteria were then analyzed for costs, effects, and other relevant economic parameters such as ICERs and sensitivity to input parameters.
RESULTS: Of the 182 studies that met the initial search criteria, 5 studies qualified for inclusion. Interventions assessed included axicabtagene ciloleucel (axi-cel; n=5), tisagenlecleucel (tisa-cel; n=4), and lisocabtagene maraleucel (liso-cel n=3). 4 studies were conducted in the US and 1 in Spain. The most common perspectives were the payer and healthcare system perspectives (n=4 and 1 respectively). All studies utilized a lifetime horizon. Axi-cel was the most cost-effective option compared to other CAR-T therapies under willingness to pay thresholds between $22,000-$150,000 and had incremental cost-effectiveness ratios (ICERs) ranging between -$609-$24,506. Liso-cel was the cost-effective option in one study, resulting in an ICER of $33,618. Models were most sensitive to drug costs, pre-progression utilities, and the number of non-intensive-care unit hospital days. Data reporting and the quality of data sources ranged from moderate to high.
CONCLUSIONS: Taken together, our results suggest that axi-cel may be the most cost-effective CAR-T therapy for r/r DLBCL. More direct head-to-head comparisons of these therapies is required to inform both future economic evaluation studies and pricing adjustments of these therapies.
METHODS: We conducted a systematic review of economic evaluation studies that compared CAR-T therapies to each other for r/r DLBCL. Studies published up to December 31st, 2024 were identified using PubMed, Embase, and Scopus and reviewed by two independent reviewers. Those meeting the inclusion criteria were then analyzed for costs, effects, and other relevant economic parameters such as ICERs and sensitivity to input parameters.
RESULTS: Of the 182 studies that met the initial search criteria, 5 studies qualified for inclusion. Interventions assessed included axicabtagene ciloleucel (axi-cel; n=5), tisagenlecleucel (tisa-cel; n=4), and lisocabtagene maraleucel (liso-cel n=3). 4 studies were conducted in the US and 1 in Spain. The most common perspectives were the payer and healthcare system perspectives (n=4 and 1 respectively). All studies utilized a lifetime horizon. Axi-cel was the most cost-effective option compared to other CAR-T therapies under willingness to pay thresholds between $22,000-$150,000 and had incremental cost-effectiveness ratios (ICERs) ranging between -$609-$24,506. Liso-cel was the cost-effective option in one study, resulting in an ICER of $33,618. Models were most sensitive to drug costs, pre-progression utilities, and the number of non-intensive-care unit hospital days. Data reporting and the quality of data sources ranged from moderate to high.
CONCLUSIONS: Taken together, our results suggest that axi-cel may be the most cost-effective CAR-T therapy for r/r DLBCL. More direct head-to-head comparisons of these therapies is required to inform both future economic evaluation studies and pricing adjustments of these therapies.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PT4
Topic
Economic Evaluation
Disease
SDC: Oncology