THE TOTAL COST OF CARE AND BUDGET IMPACT OF INTRODUCING MOSUNETUZUMAB PLUS POLATUZUMAB VEDOTIN FOR SECOND-LINE OR LATER (2L+) TREATMENT OF RELAPSED/REFRACTORY LARGE B-CELL LYMPHOMA (LBCL) TO A UNITED STATES (US) HEALTH PLAN
Author(s)
Jason Westin, MD, MS, FACP, FASCO1, David Elsea, MSc2, Kate L. Rosettie, MPH2, Anthony Masaquel, PhD, MPH2, Andrea Lo-Rossi, PhD2, Dominic Lai, PharmD2, Christopher Flowers, MD, MS, FASCO1;
1The University of Texas MD Anderson Cancer Center, Houston, TX, USA, 2Genentech, Inc., South San Francisco, CA, USA
1The University of Texas MD Anderson Cancer Center, Houston, TX, USA, 2Genentech, Inc., South San Francisco, CA, USA
OBJECTIVES: To assess total cost of care (TCC) among 2L+ treatment for relapsed/refractory LBCL and the budget impact of introducing subcutaneous mosunetuzumab plus intravenous polatuzumab vedotin (Mosun-Pola) to a hypothetical 1-million-member US health plan.
METHODS: The budget impact model included a mixed commercial/Medicare health plan across a 3-year horizon. Comparators included rituximab plus gemcitabine and oxaliplatin (R-GemOx) per the Phase 3 SUNMO trial (NCT05171647) and FDA-approved treatments, including axicabtagene ciloleucel (Axi-cel), lisocabtagene maraleucel (Liso-cel), tisagenlecleucel (Tisa-cel), tafasitamab plus lenalidomide (Tafa+len), glofitamab, epcoritamab, loncastuximab tesirine (Lonca), and polatuzumab plus bendamustine and rituximab (Pola-BR). TCC included drug and administration, grade 3-4 adverse events (AEs), all grade cytokine release syndrome (CRS) management, and routine care costs (adjusted to 2025 US dollars). Budget impact was estimated as the difference in costs per-member-per-month between the current and projected scenario (with/without Mosun-Pola). One-way sensitivity analyses (OWSA) varied model inputs by ±20%.
RESULTS: In the hypothetical health plan, 17 patients were eligible and treated. Over Year 1, TCC for Mosun-Pola ($330,237) was lower versus 2L+ treatments, including Axi-cel ($588,942), Liso-cel ($579,312) and Tafa+len ($382,187), but higher than R-GemOx ($33,114). Among 3L+ treatments, Mosun-Pola was lower than epcoritamab ($350,158) and Tisa-cel ($627,673), but higher than Lonca ($224,022), glofitamab ($226,486), and Pola-BR ($139,732). Over 3 years, net budget impact was $582,168; cost offsets included drug administration (-$29,396), grade 3-4 AEs (-$57,191) and CRS management (-$9,536). Budget impact per-member-per-month over 3 years was $0.016. OWSA showed robust results.
CONCLUSIONS: Adding Mosun-Pola to a US payer formulary resulted in a small budget impact that remained robust in OWSA. TCC for Mosun-Pola was lower versus treat-to-progression epcoritamab, Tafa+len and CAR-T regimens. Given the small budget impact and improved clinical outcomes versus R-GemOx demonstrated in the Phase 3 SUNMO trial, Mosun-Pola is a meaningful option for 2L+ relapsed/refractory LBCL.
METHODS: The budget impact model included a mixed commercial/Medicare health plan across a 3-year horizon. Comparators included rituximab plus gemcitabine and oxaliplatin (R-GemOx) per the Phase 3 SUNMO trial (NCT05171647) and FDA-approved treatments, including axicabtagene ciloleucel (Axi-cel), lisocabtagene maraleucel (Liso-cel), tisagenlecleucel (Tisa-cel), tafasitamab plus lenalidomide (Tafa+len), glofitamab, epcoritamab, loncastuximab tesirine (Lonca), and polatuzumab plus bendamustine and rituximab (Pola-BR). TCC included drug and administration, grade 3-4 adverse events (AEs), all grade cytokine release syndrome (CRS) management, and routine care costs (adjusted to 2025 US dollars). Budget impact was estimated as the difference in costs per-member-per-month between the current and projected scenario (with/without Mosun-Pola). One-way sensitivity analyses (OWSA) varied model inputs by ±20%.
RESULTS: In the hypothetical health plan, 17 patients were eligible and treated. Over Year 1, TCC for Mosun-Pola ($330,237) was lower versus 2L+ treatments, including Axi-cel ($588,942), Liso-cel ($579,312) and Tafa+len ($382,187), but higher than R-GemOx ($33,114). Among 3L+ treatments, Mosun-Pola was lower than epcoritamab ($350,158) and Tisa-cel ($627,673), but higher than Lonca ($224,022), glofitamab ($226,486), and Pola-BR ($139,732). Over 3 years, net budget impact was $582,168; cost offsets included drug administration (-$29,396), grade 3-4 AEs (-$57,191) and CRS management (-$9,536). Budget impact per-member-per-month over 3 years was $0.016. OWSA showed robust results.
CONCLUSIONS: Adding Mosun-Pola to a US payer formulary resulted in a small budget impact that remained robust in OWSA. TCC for Mosun-Pola was lower versus treat-to-progression epcoritamab, Tafa+len and CAR-T regimens. Given the small budget impact and improved clinical outcomes versus R-GemOx demonstrated in the Phase 3 SUNMO trial, Mosun-Pola is a meaningful option for 2L+ relapsed/refractory LBCL.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE461
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
SDC: Oncology