Presentation (CTI)

OBJECTIVES: Recent updates from the POLARIX Asian subgroup provide extended long-term follow-up data, alongside revisions to national pharmacoeconomic evaluation guidelines in China. In addition, polatuzumab vedotin plus R-CHP has been included in China’s National Reimbursement Drug List, warranting an updated assessment of its economic value. This study aimed to update the cost-effectiveness of polatuzumab vedotin plus R-CHP (Pola-R-CHP) compared with R-CHOP as a first-line treatment for adult DLBCL from the Chinese healthcare system perspective.
METHODS: A three-health-state partitioned survival model was developed over a lifetime horizon. Clinical efficacy inputs were derived from the updated POLARIX Asian subgroup analysis (data cut-off: July 2024). Parametric survival models were selected based on statistical goodness-of-fit and clinical plausibility. Patients remaining progression-free beyond long-term follow-up were assumed to follow general population mortality. Costs included drug acquisition, administration, adverse event management, subsequent therapies, and terminal care. A 4.5% annual discount rate was applied to costs and health outcomes in accordance with the latest Chinese pharmacoeconomic guidelines. One-way and probabilistic sensitivity analyses were conducted.
RESULTS: Over a lifetime horizon, Pola-R-CHP was associated with a modest incremental cost of ¥20,350 compared with R-CHOP, with higher upfront treatment costs largely offset by reduced use of subsequent therapies after disease progression. Pola-R-CHP generated an incremental gain of 1.68 quality-adjusted life-years. The resulting incremental cost-effectiveness ratio was ¥12,107 per QALY gained, corresponding to approximately 0.13 times China’s per-capita gross domestic product. Probabilistic sensitivity analysis showed a greater than 99% probability of Pola-R-CHP being cost-effective at a conservative willingness-to-pay threshold of 0.8 times China’s per-capita GDP.
CONCLUSIONS: Under updated long-term clinical evidence and current national pharmacoeconomic evaluation standards, Pola-R-CHP demonstrates compelling economic advantages over R-CHOP as a first-line treatment for adult DLBCL patients in China, establishing it as a high-value option in routine clinical practice.