THE PRICING BARRIER: COST-EFFECTIVENESS OF GLOFITAMAB FORRELAPSED/REFRACTORY DLBCL IN CHINA BEYOND THRESHOLD AND VALUE-BASED PRICING STRATEGY CONSIDERATIONS
Author(s)
Qing Li, bachelor1, Xiangzhen Wang, bachelor2, Lijing Yang, bachelor2, Shen Lin, master3, xiuhua weng, doctor4;
1The School of Pharmacy, Fujian Medical University, Fuzhou, China, 2Fujian Medical University, FUZHOU, China, 3Department of Pharmacy, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China, 4Good Clinical Practice Institutional Office, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
1The School of Pharmacy, Fujian Medical University, Fuzhou, China, 2Fujian Medical University, FUZHOU, China, 3Department of Pharmacy, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China, 4Good Clinical Practice Institutional Office, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
OBJECTIVES: To assessed the cost-effectiveness of Glofitamab plus gemcitabine-oxaliplatin (Glofit-GemOx) versus Rituximab-GemOx (R-GemOx) for treating relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) in China.
METHODS: A partitioned survival model utilized data from the phase 3 STARGLO trial, extrapolating progression-free survival (PFS) and overall survival (OS) via parametric distributions. Costs (2024 USD) and utilities were derived from Chinese databases, guidelines, and literature, covering drug expenses, adverse event management, and subsequent therapies. Incremental cost-effectiveness ratios (ICERs) were assessed against a willingness-to-pay (WTP) threshold of $40,343/QALY (3*China's GDP per capita, 2024). One-way and probabilistic sensitivity analyses were performed to assess model uncertainty. The budgetary impact analysis was calculated for the qualified DLBCL patients in 5 years.
RESULTS: Over a lifetime horizon, Glofit-GemOx provided 2.64 QALYs vs. 1.17 QALYs for R-GemOx, with incremental costs of $92,765 ($271,348 vs. $178,583), yielding an ICER of $63,379/QALY, which exceeded China's WTP threshold. Sensitivity analyses identified Glofitamab’s price, PFS utility, and subsequent treatment costs as key drivers. Probabilistic analysis showed only a 14.5% likelihood of Glofitamab being cost-effective at the threshold. A 30% price cut is the prerequisite for Glofitamab to reach cost-effective status. The annual budgetary consequence would decrease from $2.92 billion to $467 million in year 5.
CONCLUSIONS: Despite significantly improving survival, Glofit-GemOx is not cost-effective for R/R DLBCL in China at current pricing. Price reductions or health insurance inclusion might improve its accessibility. These findings underscore the need for value-based pricing strategies to align clinical benefits with economic sustainability in resource-limited settings.
METHODS: A partitioned survival model utilized data from the phase 3 STARGLO trial, extrapolating progression-free survival (PFS) and overall survival (OS) via parametric distributions. Costs (2024 USD) and utilities were derived from Chinese databases, guidelines, and literature, covering drug expenses, adverse event management, and subsequent therapies. Incremental cost-effectiveness ratios (ICERs) were assessed against a willingness-to-pay (WTP) threshold of $40,343/QALY (3*China's GDP per capita, 2024). One-way and probabilistic sensitivity analyses were performed to assess model uncertainty. The budgetary impact analysis was calculated for the qualified DLBCL patients in 5 years.
RESULTS: Over a lifetime horizon, Glofit-GemOx provided 2.64 QALYs vs. 1.17 QALYs for R-GemOx, with incremental costs of $92,765 ($271,348 vs. $178,583), yielding an ICER of $63,379/QALY, which exceeded China's WTP threshold. Sensitivity analyses identified Glofitamab’s price, PFS utility, and subsequent treatment costs as key drivers. Probabilistic analysis showed only a 14.5% likelihood of Glofitamab being cost-effective at the threshold. A 30% price cut is the prerequisite for Glofitamab to reach cost-effective status. The annual budgetary consequence would decrease from $2.92 billion to $467 million in year 5.
CONCLUSIONS: Despite significantly improving survival, Glofit-GemOx is not cost-effective for R/R DLBCL in China at current pricing. Price reductions or health insurance inclusion might improve its accessibility. These findings underscore the need for value-based pricing strategies to align clinical benefits with economic sustainability in resource-limited settings.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE56
Topic
Economic Evaluation
Topic Subcategory
Value of Information
Disease
SDC: Oncology