Presentation (CTI)

OBJECTIVES: Glofitamab, a bispecific antibody targeting CD3 and CD20, combined with gemcitabine and oxaliplatin (Glofit-GemOx), has demonstrated efficacy in treating relapsed or refractory diffuse large B-cell lymphoma (DLBCL). This study aimed to assess the economics of Glofit-GemOx compared to rituximab (R)-GemOx from the perspective of the Chinese healthcare system.
METHODS: A three-state partitioned survival model (progression-free survival, progressive disease, and death) was constructed based on the STARGLO study. The model was set with a cycle of 28 days and simulated over 10 years. Individual patient data were reconstructed and extrapolated in R software. The Generalized Gamma distribution was chosen as the optimal distribution for progression-free survival and overall survival of Glofit-GemOx and R-GemOx. Quality-adjusted life years (QALYs) were used as the health outcome, and the incremental cost-effectiveness ratio (ICER) was calculated. Direct medical costs including medication expenses, follow-up costs, and costs related to adverse events were considered. Drug prices were obtained from the China Data Platform, while utility values were sourced from published literature. The threshold for willingness-to-pay (WTP) was established at three times the gross domestic product in China($38,188/QALY) in 2023. One-way deterministic sensitivity analyses and probabilistic sensitivity analyses were performed on key parameters to assess the robustness of the base analysis results.
RESULTS: The costs in the Glofit-GemOx regimen were $243,222.49, while the costs in R-GemOx regimen were $43,426.37. When compared to the R-GemOx regimen, the Glofit-GemOx regimen resulted in an increment of 0.78 QALYs, yielding an ICER of $256,148.87 per QALY. The ICER significantly exceeds the WTP threshold, and sensitivity analysis revealed that the cost of glofitamab had a substantial impact on the economic outcomes.
CONCLUSIONS: The Glofit-GemOx regimen was not cost-effective compared to the RCHOP regimen for the treatment of relapsed or refractory DLBCL in China.