COST-EFFECTIVENESS OF BRENTUXIMAB VEDOTIN IN COMBINATION WITH ETOPOSIDE, DOXORUBICIN, CYCLOPHOSPHAMIDE, DACARBAZINE, AND DEXAMETHASONE (BRECADD) IN NEWLY DIAGNOSED ADVANCED STAGE HODGKIN LYMPHOMA FROM THE ITALY HEALTHCARE PERSPECTIVE
Author(s)
Silvia Ripoli, MSc1, Chiara Bini, -2, Alexa Molinari, -3, Paolo Morelli, -4, Kang Kang, -5, Denise Zou, -6, Laura Fioravanti, -1.
1Patient Value & Access, Takeda Italia SpA, Rome, Italy, 2Economic Evaluation and HTA (EEHTA CEIS), Department of Economics and Finance, Faculty of Economics, Roma, Italy, 3Takeda Pharmaceuticals America, Inc., Cambridge, MA, USA, 4Takeda Italia SpA, Rome, Italy, 5Evidera Inc., Waltham, MA, USA, 6Evidera Inc., Waltham, MN, USA.
1Patient Value & Access, Takeda Italia SpA, Rome, Italy, 2Economic Evaluation and HTA (EEHTA CEIS), Department of Economics and Finance, Faculty of Economics, Roma, Italy, 3Takeda Pharmaceuticals America, Inc., Cambridge, MA, USA, 4Takeda Italia SpA, Rome, Italy, 5Evidera Inc., Waltham, MA, USA, 6Evidera Inc., Waltham, MN, USA.
OBJECTIVES: Advanced Hodgkin lymphoma (aHL) is a rare, severe disease that affects young adults of working age and older adults. Intense systemic chemotherapy (e.g. escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone [eBEACOPP]) in the first-line (FL) setting has achieved high cure rates in aHL patients but is associated with severe, potentially lifelong toxicities. The HD21 clinical trial demonstrated that PET-guided BrECADD is better tolerated and more effective than PET-guided eBEACOPP as FL treatment in adult patients with aHL. Based on these clinical results, the study team developed an analysis to evaluate the cost-effectiveness of BrECADD versus eBEACOPP in the Italian healthcare setting.
METHODS: The developed Markov model structure with three mutually exclusive health states, weekly cycles, and a lifetime time horizon was designed to reflect the requirements of the new AIFA guideline considering the National Health Service (NHS) perspective. Transition probabilities were derived from the HD21 four-year survival data. Cost inputs were obtained from published literature and national Italian tariffs both for inpatient and outpatient visits. Of note, additional components of value associated with the BrECADD regimen (reproductive outcomes and blood transfusion burden) were explored in the analysis to assess cost-related implications.
RESULTS: BrECADD was associated with a total cost increase of € 17,499, as well as an incremental 0.33 LYs and 0.49 QALYs gained compared to eBEACOPP. Thus, the incremental cost-effectiveness ratio (ICER) and the incremental cost-utility ratio (ICUR) were estimated to be € 52,464/LY and € 35,764/QALY, respectively.
CONCLUSIONS: Considering the national willingness-to-pay observed in Italy for a more severe disease is € 41,411 per QALY gained, BrECADD is cost-effective compared to aHL intense SOC (i.e. eBEACOPP). Given the new standards as defined in AIFA guidance, these findings are crucial to informing the responsible use of intense aHL regimens to deliver superior care for patients.
METHODS: The developed Markov model structure with three mutually exclusive health states, weekly cycles, and a lifetime time horizon was designed to reflect the requirements of the new AIFA guideline considering the National Health Service (NHS) perspective. Transition probabilities were derived from the HD21 four-year survival data. Cost inputs were obtained from published literature and national Italian tariffs both for inpatient and outpatient visits. Of note, additional components of value associated with the BrECADD regimen (reproductive outcomes and blood transfusion burden) were explored in the analysis to assess cost-related implications.
RESULTS: BrECADD was associated with a total cost increase of € 17,499, as well as an incremental 0.33 LYs and 0.49 QALYs gained compared to eBEACOPP. Thus, the incremental cost-effectiveness ratio (ICER) and the incremental cost-utility ratio (ICUR) were estimated to be € 52,464/LY and € 35,764/QALY, respectively.
CONCLUSIONS: Considering the national willingness-to-pay observed in Italy for a more severe disease is € 41,411 per QALY gained, BrECADD is cost-effective compared to aHL intense SOC (i.e. eBEACOPP). Given the new standards as defined in AIFA guidance, these findings are crucial to informing the responsible use of intense aHL regimens to deliver superior care for patients.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE703
Topic
Economic Evaluation, Health Technology Assessment
Disease
Oncology