ESTIMATING THE VALUE-BASED PRICE OF EPCORITAMAB VERSUS POLATUZUMAB VEDOTIN PLUS BENDAMUSTINE AND RITUXIMAB IN RELAPSED/REFRACTORY DIFFUSE LARGE B-CELL LYMPHOMA IN EGYPT: A COST-UTILITY MODEL
Author(s)
Sandy E. Fekry, BA, MBA1, Asmaa Saad Abourawash, BSc1, Raafat Abd Elfattah, MD2, Mervat Matter, MD3.
1Pharmacoeconomics Unit, Egyptian Drug Authority, cairo, Egypt, 2National Cancer Institute, cairo, Egypt, 3faculty of medicine cairo university, cairo, Egypt.
1Pharmacoeconomics Unit, Egyptian Drug Authority, cairo, Egypt, 2National Cancer Institute, cairo, Egypt, 3faculty of medicine cairo university, cairo, Egypt.
OBJECTIVES: As value-based pricing is increasingly considered in pricing methodologies in Egypt, a cost-utility analysis comparing epcoritamab with polatuzumab vedotin plus bendamustine and rituximab (Pola-BR) was conducted. Epcoritamab offers a good treatment option for patients with relapsed or refractory diffuse large B-cell lymphoma who have failed two or more prior lines of therapy and have limited treatment options.
METHODS: A partitioned survival model was adapted to the Egyptian setting. The model comprised of three health states: progression-free, progression and death. Clinical efficacy data for epcoritamab were derived from the EPCORE NHL-1 trial, comparative efficacy versus Pola-BR was informed by indirect comparative evidence. Direct medical costs included treatment acquisition, administration, monitoring, disease management, adverse event management, and subsequent therapies. Outcomes were measured in quality-adjusted life-years (QALYs). A 20-year time horizon with 28-day cycle length was applied. Costs and outcomes were discounted at 3.5% annually. Deterministic sensitivity analysis (DSA) was performed.
RESULTS: The model yielded an incremental 2 QALYs for Epcoritamab versus Pola-BR, with an incremental cost of 113,614 USD (5,680,697 EGP) over 20 years’ time horizon. a willingness-to-pay threshold calculated as follows; Egypt's GDP per capita multiplied with a severity multiplier of 3 and rarity multiplier of 2.7 and out of pocket multiplier of 2. Based on these results, the value-based price of Epcoritamab is estimated at 4600 USD (230,000 EGP). DSA revealed that the most key parameters affecting the ICER are Hazard ratio of OS, HR of PFS and utility of PFS for Pola- BR arm.
CONCLUSIONS: Introducing Epcoritamab to Egyptian market will add huge value in treatment algorithm for RR-DBCL patients reflected in terms of improved survival and decreasing later on the disease burden.
METHODS: A partitioned survival model was adapted to the Egyptian setting. The model comprised of three health states: progression-free, progression and death. Clinical efficacy data for epcoritamab were derived from the EPCORE NHL-1 trial, comparative efficacy versus Pola-BR was informed by indirect comparative evidence. Direct medical costs included treatment acquisition, administration, monitoring, disease management, adverse event management, and subsequent therapies. Outcomes were measured in quality-adjusted life-years (QALYs). A 20-year time horizon with 28-day cycle length was applied. Costs and outcomes were discounted at 3.5% annually. Deterministic sensitivity analysis (DSA) was performed.
RESULTS: The model yielded an incremental 2 QALYs for Epcoritamab versus Pola-BR, with an incremental cost of 113,614 USD (5,680,697 EGP) over 20 years’ time horizon. a willingness-to-pay threshold calculated as follows; Egypt's GDP per capita multiplied with a severity multiplier of 3 and rarity multiplier of 2.7 and out of pocket multiplier of 2. Based on these results, the value-based price of Epcoritamab is estimated at 4600 USD (230,000 EGP). DSA revealed that the most key parameters affecting the ICER are Hazard ratio of OS, HR of PFS and utility of PFS for Pola- BR arm.
CONCLUSIONS: Introducing Epcoritamab to Egyptian market will add huge value in treatment algorithm for RR-DBCL patients reflected in terms of improved survival and decreasing later on the disease burden.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA29
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Value Frameworks & Dossier Format
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology