OBJECTIVES: To evaluate the cost-effectiveness in Taiwan of brentuximab vedotin (BV) compared with conventional chemotherapy in patients with relapsed or refractory systemic anaplastic large cell lymphoma (R/R sALCL). METHODS: A lifetime partitioned survival model was developed with three health states: progression-free/post-progression/death. An indirect comparison of the survival outcomes was made between 58 patients with R/R sALCL in a phase II, single-arm BV trial and 40 sALCL patients from a Canadian cancer registry who received conventional chemotherapy during 1980-2012 and were followed for up to 20 years. Extrapolation of BV survival after the trial period assumed the same rate of change as for conventional chemotherapy. Resource use was modelled adopting a Taiwanese National Health Insurance Administration perspective. Costs (2015 New Taiwan dollars [NT$]) considered drug acquisition and administration, adverse events management, and standard care for pre- and post-progression. Utility values elicited by response and by progression, and disutilities associated with adverse events were applied to estimate quality-adjusted life years (QALYs). Uncertainty around incremental cost/QALY gained was explored through deterministic and probabilistic sensitivity analyses. RESULTS: Over patients’ modelled lifetime, BV provided an additional 2.35 years in progression-free state and an overall survival advantage of 3.26 years. After applying utilities and discounting, the benefits translated into 1.60 and 1.87 QALYs gained, respectively. The incremental cost/QALY was NT$781,300. At a willingness-to-pay of NT$2,184,300 (triple value of Taiwan GDP), the probability that BV is cost-effective is 99%. Deterministic sensitivity analyses suggested BV’s cost-effectiveness was most sensitive to shorter time horizon, inclusion vial wastage for BV, and cost of post-progression, but was largely insensitive to alternative scenarios regarding survival functions and utilities. CONCLUSIONS: The current economic evaluation demonstrates that BV, which has demonstrated high objective response rates and is approved for R/R sALCL, may also be a cost-effective option for this patient population in Taiwan.