OBJECTIVES: The study estimates the median expenditure per patient affected by Hodgkin's lymphoma (HL) CD30+ at high risk of relapse after autologous stem-cell transplantation (ASCT). The analysis compares patients treated with brentuximab vedotin (BV) as consolidation therapy after ASCT with no treatment for consolidation (patients treated only at the time of relapse).

METHODS: A drug cost analysis was developed adopting the Italian National Health Service (NHS) perspective. With a time horizon of 3 years, the model compares direct pharmaceutical costs of the two main current pathways of treatment authorized in Italy: BV as consolidation therapy, as new paradigm, versus no consolidation therapy with patients treated only at the time of relapse with BV and nivolumab. Pharmaceutical costs were calculated considering the ex-factory prices currently reimbursed in Italy and the median duration of therapy derived from the clinical trials of interest. Time to next relapse (time to next treatment) was derived using the progression free survival (PFS) as a proxy. The model was developed in Microsoft Excel^®.

RESULTS: The median pharmaceutical cost for a patient treated with BV as consolidation therapy after ASCT was €110,552 in 3 years versus a median cost of €177,325 for a patient in the no consolidation treatment arm. In the model, administration costs and all the costs associated with eventual transplants post- relapse were not considered, the savings calculated could be underestimated. Moreover, the adoption of BV for consolidation treatment after ASCT results in approximately 45% fewer relapses compared to no consolidation therapy after ASCT.

CONCLUSIONS: The value of BV is demonstrated by the reduced number of disease progressions. The present pharmacoeconomic analysis shows that the introduction of BV as consolidation therapy after ASCT represents a sustainable expenditure for the NHS and a cost savings when compared with the drug expenditure required for treating further relapses.