Cost-Effectiveness Analysis of Axicabtagene Ciloleucel, Brexucabtagene Autoleucel, and Standard of Care for Treatment of Relapsed/Refractory Mantle Cell Lymphoma

Author(s)

Ghanem B, Brown L, Seoane-Vazquez E
Chapman University School of Pharmacy, Irvine, CA, USA

Presentation Documents

OBJECTIVES: To estimate the cost-effectiveness of axicabtagene ciloleucel versus brexucabtagene autoleucel versus standard of care (SoC) in patients with relapsed/refractory (R/R) mantle cell lymphoma (MCL) from a US healthcare payer perspective.

METHODS: A 3-state Markov model (progression-free survival, progression, and death) with a cycle length of 1 month was designed to extrapolate progression-free and overall survival (OS) over a lifetime horizon. The primary outcomes included expected life-years (LYs) and incremental cost-effectiveness ratio (ICER). Gained outcomes and adverse events were derived from pivotal trials for axicabtagene ciloleucel and brexucabtagene autoleucel and literature reviews. Drug costs were extracted from the Red Book (IBM-Micromedex), other healthcare costs were derived from the Centers for Medicare and Medicaid Services Website and literature reviews. Costs and health outcomes were discounted at 3% per year. Probabilistic sensitivity analyses were performed.

RESULTS: Discounted LYs and lifetime costs were 9.49, $630,890.49 for axicabtagene ciloleucel vs 8.99, $673,009.59 for brexucabtagene autoleucel, and 2.6, $346,637.27 for SoC respectively.

The axicabtagene ciloleucel vs. SoC ICER was $41,255.91. The brexucabtagene autoleucel vs. SoC ICER was $51,075.48. The probability that the gene therapy is cost-effective was 99% at a willingness to pay $100,000 per QALY.

CONCLUSIONS: Axicabtagene ciloleucel and brexucabtagene autoleucel are potentially cost-effective alternatives to SoC for patients with relapsed/refractory mantle cell lymphoma. More studies are necessary to confirm gene therapy's long-term safety and efficacy.

Conference/Value in Health Info

2022-05, ISPOR 2022, Washington, DC, USA

Value in Health, Volume 25, Issue 6, S1 (June 2022)

Code

EE213

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Genetic, Regenerative and Curative Therapies, Oncology, Rare and Orphan Diseases

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