COST-EFFECTIVENESS AND BUDGET IMPACT OF POLATUZUMAB VEDOTIN PLUS R-CHP VERSUS R-CHOP IN FIRST-LINE ABC DIFFUSE LARGE B-CELL LYMPHOMA IN FINLAND
Author(s)
Juha R. Laine, PhD, Lotta Koski, MSc.
Roche Oy, Espoo, Finland.
Roche Oy, Espoo, Finland.
OBJECTIVES: To evaluate the cost-effectiveness of polatuzumab vedotin with rituximab, cyclophosphamide, doxorubicin and prednisone (Pola+R-CHP) versus rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) for previously untreated diffuse large B-cell lymphoma (DLBCL) patients with activated B-cell (ABC) subtype in Finland.
METHODS: A cohort Markov model was applied using GO39942/POLARIX data (July 2024 cut-off) for the ABC population. The model used weekly cycles and a 37-year time horizon. Costs and health outcomes were discounted at 3% annually. Health states captured progression-free survival, relapse/subsequent treatment, third-line treatment, long-term survival and death. Outcomes included total costs, life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios and net monetary benefit (NMB) at a willingness-to-pay threshold of €70,000/QALY. Deterministic and probabilistic sensitivity analyses and Markov model-based budget impact were assessed.
RESULTS: In the deterministic base case, Pola+R-CHP generated 12.8 discounted LYs and 9.8 discounted QALYs versus 9.9 LYs and 7.6 QALYs with R-CHOP, yielding gains of 2.9 LYs and 2.2 QALYs. Total costs were €92,935 for Pola+R-CHP and €99,024 for R-CHOP, an incremental cost saving of €6,090. Pola+R-CHP was therefore dominant. At €70,000/QALY, deterministic NMB was €160,715. Over a short 5-year horizon, the cumulative undiscounted budget impact was approximately €2.3 million, with annual impacts of €1.5 million, €1.2 million, -€0.03 million, -€0.13 million and -€0.21 million from years 1 to 5, respectively.
CONCLUSIONS: For first-line ABC DLBCL population, Pola+R-CHP improved survival and quality-adjusted survival while reducing overall costs compared with R-CHOP. These results support Pola+R-CHP as a cost-effective, potentially cost-saving first-line option in this population in Finland.
METHODS: A cohort Markov model was applied using GO39942/POLARIX data (July 2024 cut-off) for the ABC population. The model used weekly cycles and a 37-year time horizon. Costs and health outcomes were discounted at 3% annually. Health states captured progression-free survival, relapse/subsequent treatment, third-line treatment, long-term survival and death. Outcomes included total costs, life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios and net monetary benefit (NMB) at a willingness-to-pay threshold of €70,000/QALY. Deterministic and probabilistic sensitivity analyses and Markov model-based budget impact were assessed.
RESULTS: In the deterministic base case, Pola+R-CHP generated 12.8 discounted LYs and 9.8 discounted QALYs versus 9.9 LYs and 7.6 QALYs with R-CHOP, yielding gains of 2.9 LYs and 2.2 QALYs. Total costs were €92,935 for Pola+R-CHP and €99,024 for R-CHOP, an incremental cost saving of €6,090. Pola+R-CHP was therefore dominant. At €70,000/QALY, deterministic NMB was €160,715. Over a short 5-year horizon, the cumulative undiscounted budget impact was approximately €2.3 million, with annual impacts of €1.5 million, €1.2 million, -€0.03 million, -€0.13 million and -€0.21 million from years 1 to 5, respectively.
CONCLUSIONS: For first-line ABC DLBCL population, Pola+R-CHP improved survival and quality-adjusted survival while reducing overall costs compared with R-CHOP. These results support Pola+R-CHP as a cost-effective, potentially cost-saving first-line option in this population in Finland.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE224
Topic
Economic Evaluation, Health Technology Assessment
Topic Subcategory
Budget Impact Analysis
Disease
Oncology