Budget Impact Analysis of Obecabtagene Autoleucel for Adults With Relapsed/Refractory B-cell ALL From a US Payer Perspective
Author(s)
Annika Bjerke, MS1, Spencer Notinger, MS1, Jeff Lee, PharmD, FCCP1, dilip Patel, BSc2, David Bertwistle, BSc, MSc, PhD2, David Huggar, MS, PharmD3.
1Lumanity, Inc., Boston, MA, USA, 2Autolus Ltd, London, United Kingdom, 3Autolus Therapeutics, San Antonio, TX, USA.
1Lumanity, Inc., Boston, MA, USA, 2Autolus Ltd, London, United Kingdom, 3Autolus Therapeutics, San Antonio, TX, USA.
OBJECTIVES: Treatments for relapsed/refractory (r/r) B-cell acute lymphocytic leukemia (ALL) in the US include chemotherapies, immunotherapies, and chimeric antigen receptor T (CAR T) cell therapies. Obecabtagene autoleucel (obe-cel) is a CAR T therapy approved by the US FDA in November 2024 to treat r/r B-cell ALL. A model was created to estimate the budget impact of adding obe-cel to a US healthcare plan formulary for adults with r/r B-cell ALL.
METHODS: This budget impact analysis compares 5-year costs of reference (without obe-cel) versus new drug (with obe-cel) scenarios for a US health plan with 1,000,000 members. Target population estimates use US epidemiology data; market share estimates are informed by claims data. The analysis includes costs for drug acquisition, administration, CAR T preparation and hospitalization, subsequent treatment, and adverse event (AE) management. Obe-cel is assumed to displace market share for the comparator CAR T therapy, brexucabtagene autoleucel.
RESULTS: For a 1,000,000-member US health plan, approximately four patients are eligible for r/r B-cell ALL treatment with obe-cel each year. With the introduction of obe-cel, average per member per month costs decrease by $0.0024 over 5 years; total estimated annual budget impact ranges from -$10,539 in Year 1 to -$48,155 in Year 5, with a 5-year average of -$28,612. The negative budget impact is driven by cost offsets in AE management, with a 5-year average of -$29,312 and hospitalization, with a 5-year average of -$56,685. One-way sensitivity analysis identifies drug acquisition costs and mean post-infusion hospital days for both CAR T therapies as key results drivers. Additional scenarios will be reported.
CONCLUSIONS: The analysis estimates that for a hypothetical 1,000,000-member US healthcare plan, the introduction of obe-cel results in a negative budget impact for treating r/r B-cell ALL over 5 years, driven by cost offsets in AE management and hospitalization.
METHODS: This budget impact analysis compares 5-year costs of reference (without obe-cel) versus new drug (with obe-cel) scenarios for a US health plan with 1,000,000 members. Target population estimates use US epidemiology data; market share estimates are informed by claims data. The analysis includes costs for drug acquisition, administration, CAR T preparation and hospitalization, subsequent treatment, and adverse event (AE) management. Obe-cel is assumed to displace market share for the comparator CAR T therapy, brexucabtagene autoleucel.
RESULTS: For a 1,000,000-member US health plan, approximately four patients are eligible for r/r B-cell ALL treatment with obe-cel each year. With the introduction of obe-cel, average per member per month costs decrease by $0.0024 over 5 years; total estimated annual budget impact ranges from -$10,539 in Year 1 to -$48,155 in Year 5, with a 5-year average of -$28,612. The negative budget impact is driven by cost offsets in AE management, with a 5-year average of -$29,312 and hospitalization, with a 5-year average of -$56,685. One-way sensitivity analysis identifies drug acquisition costs and mean post-infusion hospital days for both CAR T therapies as key results drivers. Additional scenarios will be reported.
CONCLUSIONS: The analysis estimates that for a hypothetical 1,000,000-member US healthcare plan, the introduction of obe-cel results in a negative budget impact for treating r/r B-cell ALL over 5 years, driven by cost offsets in AE management and hospitalization.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE92
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Oncology, Rare & Orphan Diseases