Healthcare Resource Utilization in the Management of Patients with Relapse/Refractory Mantle Cell Lymphoma in Canada
Author(s)
Kimberly Guinan, MSc.1, Monika Ham, MSc.1, Harpreet Singh, MSc.2, Nancy Paul Roc, MSc2, Hardeek Patel, MD2, Peter Anglin, MD3, Christopher Lemieux, MD4, Beenish Manzoor, MPH, PhD5, Stephane Barakat, PhD2, Jean Lachaine, PhD1;
1PeriPharm Inc., Montreal, QC, Canada, 2AbbVie Corporation, Saint-Laurent, QC, Canada, 3Southlake Regional Health Centre, Newmarket, ON, Canada, 4CHU de Québec – Université Laval, Quebec, QC, Canada, 5AbbVie Inc., North Chicago, IL, USA
1PeriPharm Inc., Montreal, QC, Canada, 2AbbVie Corporation, Saint-Laurent, QC, Canada, 3Southlake Regional Health Centre, Newmarket, ON, Canada, 4CHU de Québec – Université Laval, Quebec, QC, Canada, 5AbbVie Inc., North Chicago, IL, USA
Presentation Documents
OBJECTIVES: Currently, there are no Canadian healthcare resource utilization (HCRU) studies published in relapse/refractory mantle cell lymphoma (R/R-MCL). Venetoclax in combination with ibrutinib (V+I) was evaluated for the treatment of R/R-MCL in the SYMPATICO trial. This study aimed to estimate HCRU costs of V+I compared to current treatment options used for R/R-MCL, in order to inform health technology assessment agencies, institutional decision makers and healthcare professionals, from a Canadian and Quebec perspective.
METHODS: A costing analysis was developed comparing V+I to current treatment options, over a time horizon determined by treatment-specific median durations. Comparative treatments were divided into second-line (2L) and third-line (3L) therapies for R/R-MCL. Comparators in 2L included Bruton’s tyrosine kinase inhibitors (BTKis) and chemo-immunotherapies whereas 3L comparators also included brexucaptagene autoleucel (brexu-cel), venetoclax, lenalidomide, and allogeneic stem cell transplant (allo-SCT), in addition to BTKis. From a healthcare system perspective, costs included pretreatment, administration/monitoring, and adverse events. From a societal perspective, indirect costs were also included. Model inputs were retrieved from product labels and were validated by Canadian clinical experts to reflect practice.
RESULTS: Among 2L treatments, V+I offers HCRU cost savings compared to chemo-immunotherapies. Compared to ibrutinib, the only reimbursed BTKi in 2L, the addition of venetoclax to ibrutinib as a combination therapy generates additional HCRU cost of $2,236 in Canada and $1,929 in Quebec, while providing a longer median progression-free survival (PFS), as demonstrated in the SYMPATICO trial (V+I: 31.9 months vs ibrutinib: 22.1 months). The highest HCRU cost burden in managing R/R-MCL is sourced from patients receiving 3L therapies. Among all treatments in 3L, allo-SCT and brexu-cel lead to the highest HCRU costs. Results remain similar from a societal perspective.
CONCLUSIONS: By offering a longer PFS in 2L, V+I could delay the need for a 3L treatment along with their substantial HCRU costs and burden.
METHODS: A costing analysis was developed comparing V+I to current treatment options, over a time horizon determined by treatment-specific median durations. Comparative treatments were divided into second-line (2L) and third-line (3L) therapies for R/R-MCL. Comparators in 2L included Bruton’s tyrosine kinase inhibitors (BTKis) and chemo-immunotherapies whereas 3L comparators also included brexucaptagene autoleucel (brexu-cel), venetoclax, lenalidomide, and allogeneic stem cell transplant (allo-SCT), in addition to BTKis. From a healthcare system perspective, costs included pretreatment, administration/monitoring, and adverse events. From a societal perspective, indirect costs were also included. Model inputs were retrieved from product labels and were validated by Canadian clinical experts to reflect practice.
RESULTS: Among 2L treatments, V+I offers HCRU cost savings compared to chemo-immunotherapies. Compared to ibrutinib, the only reimbursed BTKi in 2L, the addition of venetoclax to ibrutinib as a combination therapy generates additional HCRU cost of $2,236 in Canada and $1,929 in Quebec, while providing a longer median progression-free survival (PFS), as demonstrated in the SYMPATICO trial (V+I: 31.9 months vs ibrutinib: 22.1 months). The highest HCRU cost burden in managing R/R-MCL is sourced from patients receiving 3L therapies. Among all treatments in 3L, allo-SCT and brexu-cel lead to the highest HCRU costs. Results remain similar from a societal perspective.
CONCLUSIONS: By offering a longer PFS in 2L, V+I could delay the need for a 3L treatment along with their substantial HCRU costs and burden.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE355
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology, STA: Biologics & Biosimilars