Impact of CAR T-Cell Therapy on Health Utilities for Patients Diagnosed With Diffuse Large B-Cell Lymphoma in Canada
Author(s)
Masucci L1, Prica A2, Coley T3, Kuruvilla J3, Sander B4, Chan KKW5, Wong WW6
1University of Toronto, Toronto, ON, Canada, 2Princess Margaret Hospital, Toronto, ON, Canada, 3Princess Margaret Cancer Centre, Toronto, ON, Canada, 4University Health Network, Toronto, ON, Canada, 5University of Ottawa, Ottawa, ON, Canada, 6University of Waterloo, Kitchener, ON, Canada
OBJECTIVES: Chimeric antigen receptor T-cell (CAR T) therapy is a novel therapy that has shown to improve survival for patients with diffuse large B-cell lymphoma (DLBCL), but it comes at a high cost. Cost-effectiveness models evaluating CAR T have relied mainly on clinical trial data, and are unlikely to reflect real-world effectiveness. The purpose of this research was to determine the health utilities of patients who received CAR T in a real-world setting.
METHODS: A longitudinal study was conducted to measure the health utilities of patients who received CAR T at Princess Margaret Hospital, Toronto, Ontario, between 04/20/2022-03/31/2023. Each patient was assessed at four timepoints: baseline (pre-treatment), 2-weeks, 3-months, and 6-months post-treatment. At each timepoint, patients completed a self-reported utility instrument (EQ-5D-5L), and a cancer specific psychometric measure (EORTC QLQ C-30). EQ-5D-5L and EORTC QLQ C-30 were converted to utility values using the Canadian value set. The EORTC QLQ C-30 was converted to the QLU-C10D. Descriptive analysis was conducted, the mean utility scores and mean change from baseline were calculated.
RESULTS: A total of 43 patients were included, the mean age was 57 years, 53% were male. 42% of patients progressed by 6-months. The mean EQ-5D-5L scores were 0.83 (SD=0.12) at baseline, 0.77 (SD=0.21) at 2-weeks post-treatment, 0.76 (SD=0.22) at 3-months post-treatment, and 0.78 (SD=0.18) at 6-months post-treatment. The mean QLU-C10D scores were 0.68 (SD=0.22), 0.53 (SD=0.29), 0.62 (SD=0.34), and 0.66 (SD=0.30) at each timepoint, respectively. The mean EQ-5D-5L scores at 6-months were 0.58 (SD=0.12) for those who progressed versus 0.83 (SD=0.12) for those who were progression-free.
CONCLUSIONS: Comparing with a minimal clinically important difference of 0.056, our results suggest that patients who receive CAR T at 6-months follow-up still have a clinically meaningful impact on health utility. These estimates are important for future economic analysis in the upcoming re-evaluation.
Conference/Value in Health Info
Value in Health, Volume 27, Issue 12, S2 (December 2024)
Code
PCR105
Topic
Patient-Centered Research
Topic Subcategory
Health State Utilities, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Drugs, Oncology