THE COST-EFFECTIVENESS ANALYSIS OF INATICABTAGENE AUTOLEUCEL FOR RELAPSED/REFRACTORY B-CELL ACUTE LYMPHOBLASTIC LEUKEMIA PATIENTS IN CHINA
Author(s)
Yuantong Li, MS1, Liqi Zhang, BA1, Xiaoning He, PhD1, Lulu lv, PhD2, Jing Wu, PhD1;
1Tianjin University, Tianjin, China, 2Juventas CO.Ltd, Tianjin, China
1Tianjin University, Tianjin, China, 2Juventas CO.Ltd, Tianjin, China
OBJECTIVES: Inaticabtagene autoleucel, a novel CAR-T cell therapy, has been approved in China for patients with relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL). Given its high upfront cost and potential for survival benefits, this study aimed to evaluate the cost-effectiveness of inaticabtagene autoleucel compared with blinatumomab, inotuzumab ozogamicin, and allogeneic hematopoietic stem-cell transplantation (allo-HSCT) from the Chinese healthcare system perspective.
METHODS: An economic model was developed, combining a decision tree with a partitioned survival model to project lifetime costs and health outcomes. Three health states were included: relapse-free, relapsed/progressive disease, and death. Comparative effectiveness was estimated using an unanchored matching-adjusted indirect comparison (MAIC) to balance baseline characteristics across trials. Long-term survival was extrapolated using parametric mixture cure models to capture the potential curative effect of CAR-T therapy. Costs and health outcomes were evaluated over a lifetime horizon, discounted at an annual rate of 5%; the partitioned survival model used a 1-month cycle length. Model inputs were derived from published literature.
RESULTS: Inaticabtagene autoleucel (assumed price: CN¥999,000 / US$142,714) provided longer survival with increased lifetime healthcare costs compared to alternative treatments. Compared to blinatumomab, it provided an additional 2.32 quality-adjusted life years (QALYs) at an incremental cost of CN¥207,240 (US$29,600), yielding an incremental cost-effectiveness ratio (ICER) of CN¥89,837 per QALY (US$12,840). Compared with inotuzumab ozogamicin, it yielded 2.55 additional QALYs at incremental costs of CN¥261,084 (US$37,300) with an ICER of CN¥102,281 (US$14,619) per QALY, and 3.06 additional QALYs versus allo-HSCT at incremental costs of CN¥569,647 (US$81,400), yielding an ICER of CN¥185,957 (US$26,579) per QALY.
CONCLUSIONS: From the Chinese healthcare system perspective, inaticabtagene autoleucel is likely to be cost-effective for patients with R/R B-ALL when a willingness-to-pay threshold of twice the gross domestic product (GDP) per capita is applied. These findings informed the reimbursement and coverage decision-making for CAR-T cell therapies in China.
METHODS: An economic model was developed, combining a decision tree with a partitioned survival model to project lifetime costs and health outcomes. Three health states were included: relapse-free, relapsed/progressive disease, and death. Comparative effectiveness was estimated using an unanchored matching-adjusted indirect comparison (MAIC) to balance baseline characteristics across trials. Long-term survival was extrapolated using parametric mixture cure models to capture the potential curative effect of CAR-T therapy. Costs and health outcomes were evaluated over a lifetime horizon, discounted at an annual rate of 5%; the partitioned survival model used a 1-month cycle length. Model inputs were derived from published literature.
RESULTS: Inaticabtagene autoleucel (assumed price: CN¥999,000 / US$142,714) provided longer survival with increased lifetime healthcare costs compared to alternative treatments. Compared to blinatumomab, it provided an additional 2.32 quality-adjusted life years (QALYs) at an incremental cost of CN¥207,240 (US$29,600), yielding an incremental cost-effectiveness ratio (ICER) of CN¥89,837 per QALY (US$12,840). Compared with inotuzumab ozogamicin, it yielded 2.55 additional QALYs at incremental costs of CN¥261,084 (US$37,300) with an ICER of CN¥102,281 (US$14,619) per QALY, and 3.06 additional QALYs versus allo-HSCT at incremental costs of CN¥569,647 (US$81,400), yielding an ICER of CN¥185,957 (US$26,579) per QALY.
CONCLUSIONS: From the Chinese healthcare system perspective, inaticabtagene autoleucel is likely to be cost-effective for patients with R/R B-ALL when a willingness-to-pay threshold of twice the gross domestic product (GDP) per capita is applied. These findings informed the reimbursement and coverage decision-making for CAR-T cell therapies in China.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE272
Topic
Economic Evaluation
Disease
SDC: Oncology