COST-EFFECTIVENESS OF SUBCUTANEOUS MOSUNETUZUMAB PLUS POLATUZUMAB VEDOTIN VERSUS RITUXIMAB PLUS GEMCITABINE AND OXALIPLATIN FOR UNITED STATES (US) PATIENTS WITH AUTOLOGOUS STEM CELL TRANSPLANT-INELIGIBLE RELAPSED/REFRACTORY LARGE B-CELL LYMPHOMA
Author(s)
Jason Westin, MD, MS, FACP, FASCO1, Kate Rosettie, MPH2, Anthony Masaquel, PhD, MPH2, David Elsea, MSc2, Hazal Celik, MPharm, MSc3, Michael Seo, PhD3, Dominic Lai, PharmD2, Andrea Lo-Rossi, PhD2, Christopher Flowers, MD, MS, FASCO1;
1The University of Texas MD Anderson Cancer Center, Houston, TX, USA, 2Genentech, Inc., South San Francisco, CA, USA, 3F. Hoffmann-La Roche Ltd, Basel, Switzerland
1The University of Texas MD Anderson Cancer Center, Houston, TX, USA, 2Genentech, Inc., South San Francisco, CA, USA, 3F. Hoffmann-La Roche Ltd, Basel, Switzerland
OBJECTIVES: To conduct a cost-effectiveness analysis of subcutaneous mosunetuzumab plus polatuzumab vedotin (Mosun-Pola) versus rituximab plus gemcitabine and oxaliplatin (R-GemOx) in patients with transplant-ineligible relapsed/refractory LBCL from a US payer perspective.
METHODS: A partition survival model was used to estimate quality-adjusted life years (QALYs) and life years (LYs) gained, direct healthcare costs, and incremental cost-effectiveness ratios (ICERs) for Mosun-Pola versus R-GemOx, across a patient’s lifetime. Data from the SUNMO trial (NCT05171647) were used to extrapolate clinical outcomes (progression-free survival and overall survival). Direct healthcare costs included drug (based on Medicare Average Sales Price [Q4 2025]) and administration, grade 3+ adverse event (AE), subsequent treatment, routine and terminal care, and all grade cytokine release syndrome monitoring costs. Future costs and benefits were discounted at an annual rate of 3%. A willingness to pay (WTP) threshold of $150,000/QALY gained was used to demonstrate cost-effectiveness. A one-way sensitivity analysis (OWSA), that varied model inputs by ±20%, and a probabilistic sensitivity analysis (PSA) were conducted to assess the robustness of the results.
RESULTS: Mosun-Pola was associated with an incremental cost of $139,644 and an improvement in QALYs (1.26) and LYs (1.01) versus R-GemOx, leading to an ICER of $111,234/QALY. Incremental costs were driven by increased drug treatment and administration ($269,104) and AE costs ($1,564) and decreased supportive care (-$28,037), subsequent treatment (-$102,163) and terminal care costs (-$825). The OWSA found that the model was most sensitive to post-progression utility and subsequent treatment costs. At the WTP threshold of $150,000/QALY, the PSA found that Mosun-Pola was cost-effective versus R-GemOx in 71% of scenarios.
CONCLUSIONS: Mosun-Pola provided a clinical benefit, with increased QALYs and LYs, and was associated with lower supportive care and progression-related costs versus R-GemOx. At the WTP threshold of $150,000/QALY, Mosun-Pola was cost-effective versus R-GemOx in patients with transplant ineligible LBCL, from a US payer perspective.
METHODS: A partition survival model was used to estimate quality-adjusted life years (QALYs) and life years (LYs) gained, direct healthcare costs, and incremental cost-effectiveness ratios (ICERs) for Mosun-Pola versus R-GemOx, across a patient’s lifetime. Data from the SUNMO trial (NCT05171647) were used to extrapolate clinical outcomes (progression-free survival and overall survival). Direct healthcare costs included drug (based on Medicare Average Sales Price [Q4 2025]) and administration, grade 3+ adverse event (AE), subsequent treatment, routine and terminal care, and all grade cytokine release syndrome monitoring costs. Future costs and benefits were discounted at an annual rate of 3%. A willingness to pay (WTP) threshold of $150,000/QALY gained was used to demonstrate cost-effectiveness. A one-way sensitivity analysis (OWSA), that varied model inputs by ±20%, and a probabilistic sensitivity analysis (PSA) were conducted to assess the robustness of the results.
RESULTS: Mosun-Pola was associated with an incremental cost of $139,644 and an improvement in QALYs (1.26) and LYs (1.01) versus R-GemOx, leading to an ICER of $111,234/QALY. Incremental costs were driven by increased drug treatment and administration ($269,104) and AE costs ($1,564) and decreased supportive care (-$28,037), subsequent treatment (-$102,163) and terminal care costs (-$825). The OWSA found that the model was most sensitive to post-progression utility and subsequent treatment costs. At the WTP threshold of $150,000/QALY, the PSA found that Mosun-Pola was cost-effective versus R-GemOx in 71% of scenarios.
CONCLUSIONS: Mosun-Pola provided a clinical benefit, with increased QALYs and LYs, and was associated with lower supportive care and progression-related costs versus R-GemOx. At the WTP threshold of $150,000/QALY, Mosun-Pola was cost-effective versus R-GemOx in patients with transplant ineligible LBCL, from a US payer perspective.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE356
Topic
Economic Evaluation
Disease
SDC: Oncology