COST-EFFECTIVENESS ANALYSIS OF RELMACABTAGENE AUTOLEUCEL VERSUS IMMUNOCHEMOTHERAPY IN PATIENTS WITH RELAPSED OR REFRACTORY LARGE B-CELL LYMPHOMA (R/R LBCL) WHO HAVE FAILED AT LEAST TWO LINES OF SYSTEMIC THERAPY IN CHINA
Author(s)
Keqin Gao, MSc1, Powei Wu, MSc1, Yifan Jiang, MSc1, Yifei Jian, MSc1, Poucheok Pang, MSc1, Chenyu Zuo, MSc1, Yang Li, MSc2, Jianwei Xuan, PhD1.
1Health Economic Research Institute, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China, 2JW Therapeutics (Shanghai) Co. Ltd, Shanghai, China.
1Health Economic Research Institute, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China, 2JW Therapeutics (Shanghai) Co. Ltd, Shanghai, China.
Presentation Documents
OBJECTIVES: To evaluate the cost-effectiveness of relmacabtagene autoleucel (Relma-cel) versus salvage immunochemotherapy with or without autologous stem cell transplantation (IC±ASCT) for adult patients with relapsed/refractory large B-cell lymphoma (r/r LBCL) from the perspective of the Chinese healthcare system.
METHODS: A partitioned survival model incorporating a mixture cure model (MCM) was constructed. Efficacy data for Relma-cel were derived from the RELIANCE trial, while control arm data were from the SCHOLAR-1 study. To mitigate the structural uncertainty in modeling long-term survival for potentially curative CAR-T therapies and address the limitations of single-method adjustments for cross-trial heterogeneity, a robust dual-approach strategy employing both Matching-Adjusted Indirect Comparison (MAIC) and Simulated Treatment Comparison (STC) was utilized. Costs and utilities were sourced from clinical trials and expert surveys. The willingness-to-pay (WTP) threshold was two times China's 2024 GDP per capita (¥191,498/QALY).
RESULTS: In the base-case analysis, Relma-cel yielded an additional 5.01 quality-adjusted life years (QALYs) (ICER: ¥90,198/QALY) using MAIC and 9.23 QALYs (ICER: ¥130,705/QALY) using STC. While the magnitude of survival benefit varied by method, the projected QALY gains (5.01-9.23) align well with the ranges reported in international economic evaluations of CAR-T therapies, confirming the plausibility of the results. Both ICERs were significantly below the WTP threshold. Probabilistic sensitivity analyses confirmed robustness, with Relma-cel being cost-effective in 100% (MAIC) and 96.1% (STC) of simulations.
CONCLUSIONS: As a domestic CAR-T product, Relma-cel represents a cost-effective option compared to standard salvage therapies for Chinese r/r LBCL patients. The consistency of favorable economic outcomes across two distinct indirect comparison methods reinforces the reliability of these findings, effectively validating the model's conclusions despite the inherent challenges of cross-trial evaluations.
METHODS: A partitioned survival model incorporating a mixture cure model (MCM) was constructed. Efficacy data for Relma-cel were derived from the RELIANCE trial, while control arm data were from the SCHOLAR-1 study. To mitigate the structural uncertainty in modeling long-term survival for potentially curative CAR-T therapies and address the limitations of single-method adjustments for cross-trial heterogeneity, a robust dual-approach strategy employing both Matching-Adjusted Indirect Comparison (MAIC) and Simulated Treatment Comparison (STC) was utilized. Costs and utilities were sourced from clinical trials and expert surveys. The willingness-to-pay (WTP) threshold was two times China's 2024 GDP per capita (¥191,498/QALY).
RESULTS: In the base-case analysis, Relma-cel yielded an additional 5.01 quality-adjusted life years (QALYs) (ICER: ¥90,198/QALY) using MAIC and 9.23 QALYs (ICER: ¥130,705/QALY) using STC. While the magnitude of survival benefit varied by method, the projected QALY gains (5.01-9.23) align well with the ranges reported in international economic evaluations of CAR-T therapies, confirming the plausibility of the results. Both ICERs were significantly below the WTP threshold. Probabilistic sensitivity analyses confirmed robustness, with Relma-cel being cost-effective in 100% (MAIC) and 96.1% (STC) of simulations.
CONCLUSIONS: As a domestic CAR-T product, Relma-cel represents a cost-effective option compared to standard salvage therapies for Chinese r/r LBCL patients. The consistency of favorable economic outcomes across two distinct indirect comparison methods reinforces the reliability of these findings, effectively validating the model's conclusions despite the inherent challenges of cross-trial evaluations.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE150
Topic
Economic Evaluation
Disease
SDC: Oncology, STA: Biologics & Biosimilars, STA: Genetic, Regenerative & Curative Therapies