OBJECTIVES: Innovation in the treatment of aggressive B-cell lymphomas has been limited for nearly 20 years since the introduction of rituximab in the late 1990s. The aim of this study was to establish a baseline of the historical efforts in modeling the health economic value of healthcare technologies in the treatment of aggressive B-cell lymphomas.

METHODS: A focused literature review covering peer-reviewed publications from January 1997 through August 2017 was conducted in MEDLINE. The search strategy included search terms specific to study design, disease and healthcare interventions. Only full text, English only articles were included for evaluation. Articles for inclusion followed a practical approach including a 1^st pass of titles and abstracts followed by a 2^nd pass of full-text and a final decision for inclusion and data extraction. Variables collected included model design and structure and results.

RESULTS: A total of 1,415 articles were identified, 77 reviewed and 9 included for full extraction. Most of the models focused on the US (n = 2) and UK (n = 2), were of a Markov structure (n = 4; 44.4%) and focused on the payer perspective (n = 6; 66.6%). Nearly all the models evaluated rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) as the intervention (n = 6; 66.6%) and were focused on 1^st line therapy (n = 7; 77.8%). No models were identified evaluating stem cell transplantation and other forms of salvage chemotherapy. All models focused on life expectancy, but only 1 study of the analyses demonstrated survival gains greater than 1 year relative to the comparator selected.

CONCLUSIONS: A lack of innovation in the space has resulted in limited evidence to form a baseline for efforts of modeling in aggressive B-cell lymphomas. Real-world prospective cost and outcome studies would promote advances in informing, both clinical and economic factors for future treatment decision models.