OBJECTIVES: Up until 2022, chemotherapy was the only therapy available in Brazil for patients with relapsed or refractory diffuse large B-cell lymphoma who are not transplant eligible (NTE R/R DLBCL). Currently, tafasitamab and polatuzumab have ANVISA registration for this indication, as well as axicabtagene ciloleucel (Axi-C) which has a broad indication. The objective was to assess the cost-effectiveness and efficiency frontier of tafasitamab in combination with lenalidomide (Tafa-len) compared with therapies available for 2^nd line NTE R/R DLBCL in the Brazilian private healthcare system (PHS).

METHODS: A partitioned survival model, of three health states – progression-free survival (PFS), overall survival (OS), and death – was developed. Patients begin the simulation in PFS and, over time, can move to different health states in 4-week cycles with a lifetime time horizon. Clinical parameters were extracted from L-MIND and MAIC studies, while costs were extracted from the CMED list price, CBHPM list and the polatuzumab NICE evaluation. The comparators were Pola-BR, R-Gemox, R-DHAP and R-ICE. An alternative scenario was considered with Axi-C. Sensitivity analyses were conducted to assess impact of varying the inputs on the model results.

RESULTS: The analysis of Tafa-len presented a ICUR of R$ 55,266, R$ 278,539, R$ 355,450 and R$359,492 compared to Pola-BR, R-GemOx, R-DHAP and R-ICE, respectively. Tafa-len was considered dominant when compared to Axi-C. The efficiency frontier showed that rituximab-based regimens had much lower effectiveness compared with tafasitamab.

CONCLUSIONS: Tafa-len is an effective and economical therapeutic option for DLBCL patients providing more QALYs than other options.