OBJECTIVES: To assess the cost-effectiveness of obinutuzumab combined with chemotherapy followed by maintenance therapy with obinutuzumab (OCC) relative to rituximab combined with chemotherapy followed by maintenance therapy with rituximab (RCC) in Chinese treatment naïve patients with advanced follicular lymphoma (FL).

METHODS: A cost-effectiveness model was constructed using Markov partitioned survival model with three health states (disease remission, progressive disease, and mortality) to assess the cost-effectiveness of OCC relative to RCC in the Chinese treatment naïve patients with advanced FL over a 40-year time horizon. Both health benefits and costs were discounted as 5% per year. GALLIUM trial and PRIMA trial were the data sources for treatment effects and health utility. FL patients and oncologists treating FL across China were enrolled to survey treatment pattern, direct medical costs, indirect costs associated with FL in China. The cost-effectiveness analysis was conducted from the Chinese societal perspective.

RESULTS: When compared to RCC, OCC could gain 0.877 quality adjusted life year (QALY) (9.225 QALY vs. 8.348 QALY), saved CNY 41,371 for direct medical costs (CNY 279,965 vs. CNY 321,336) and CNY 28,289 for indirect costs (CNY 136,758 vs. CNY 165,047) associated with progressive disease in the base case cost-effectiveness analysis. When the unit price of obinutuzumab was lower than CNY 22,115, the cost-effectiveness of OCC relative to RCC was attractive under the recommended cost-effectiveness threshold (3 times of the China gross domestic products per capital in 2020: CNY 217,341).

CONCLUSIONS: Based on the best available evidence, 40-year time horizon simulation of the cost-effectiveness model indicated that OCC could gain more health benefits and save both direct medical costs and indirect costs associated with progressive disease when compared to RCC in Chinese treatment naïve patients with advanced FL. The unit price of obinutuzumab was likely to drive the cost-effectiveness of OCC.