OBJECTIVES : In France, Diagnosis-related Groups (DRG)–based payment is the main hospital funding system. For hospital-restricted products with an acquisition cost >30% of the DRG payment and without external funding through the “liste-en-sus,” there is an affordability issue. One hospital-restricted product that falls in this category is CPX-351 (Vyxeos® Liposomal), a dual-drug liposomal encapsulation of cytarabine/daunorubicin at a synergistic 5:1 molar ratio that is indicated for patients with newly diagnosed t-AML and AML-MRC. The objective of this study was to develop a BIM to assess affordability at the hospital level.

METHODS : We developed a BIM comparing CPX-351 to conventional cytarabine/daunorubicin chemotherapy (7+3 regimen). The BIM followed a dynamic cohort entering the model every year over 3 years. Hospital data (PMSI) recommended by the French HTA were used to estimate costs and revenues related to the interventions and patient pathway (induction, consolidation, and hematopoietic cell transplantation [HCT]). All costs and revenues were assessed from a hospital perspective. All relevant clinical parameters (target population and patient pathway) are editable to enable adaptation at the hospital level. Model base case parameters/inputs are based on Study 301 (Lancet J, Clin Oncol 2018;36:2684-2692) and French real-world data.

RESULTS : At a national level, the introduction of CPX-351 increases total costs (+36%) and total revenues (+10%) for the hospitals . Costs are driven by the acquisition cost of CPX-351 and revenues by HCT. The use of CPX-351 results in more patients proceeding to transplant versus 7+3, generating more transplant-related revenue (+31%) for hospitals.

CONCLUSIONS : Economic assessment of a new healthcare intervention, including the BIM, is a relevant decision-support tool for many stakeholders within the health system. At the hospital level, it helps to evaluate the affordability of new products, which may lead to greater accessibility across the country.