COST-MINIMISATION ANALYSIS OF SUBCUTANEOUS VS INTRAVENOUS RITUXIMAB FOR THE TREATMENT OF FOLLICULAR LYMPHOMA AND DIFFUSE LARGE B-CELL LYMPHOMA IN SINGAPORE

Author(s)

Choi MH1, Lim S1, Wong A2
1Costello Medical Singapore Pte. Ltd., Singapore, Singapore, 2Roche Singapore Pte. Ltd., Singapore, Singapore

OBJECTIVES: Diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) are the most common types of Non-Hodgkin’s lymphomas in Singapore. Rituximab is the first-line treatment for DLBCL and FL, either in combination with chemotherapy or as monotherapy. The efficacy and safety of subcutaneous (SC) rituximab is non-inferior compared to intravenous (IV) rituximab, and is anticipated to be used interchangeably with IV rituximab in FL and DLBCL. This study investigated differences in drug and non-drug costs of SC vs. IV rituximab for the treatment of patients with FL and DLBCL in Singapore. METHODS: A cost-minimisation analysis compared the drug and non-drugs costs of using SC vs. IV rituximab. Clinical and cost inputs were obtained from field interviews and patient bills in public-sector hospitals. Total costs of rituximab were calculated over 6 cycles of rituximab+chemotherapy followed by 8 cycles of rituximab monotherapy for FL, and 6 cycles of rituximab+chemotherapy for DLBCL. Drug costs for IV rituximab were calculated using a mean body surface area of 1.67 mst cycle of rituximab using the IV formulation. Non-drug costs included pre-medications, drug preparation, venous access, rituximab administration, and facilities. RESULTS: The analysis demonstrated that treatment using SC vs. IV rituximab resulted in drug cost-savings of 3.8% (S$47,164 vs. S$49,050) for the FL population and 3.5% (S$20,296 vs. S$21,022) for the DLBCL population. Non-drug costs were reduced by 47.0% (S$1,457 vs. S$2,746) for the FL population and by 21.2% (S$927 vs. S$1,177) for the DLBCL population. Overall costs were reduced by 6.1% ($48,620 vs. $51,797) in FL and by 4.4% ($21,223 vs. $22,199) in DLBCL. CONCLUSIONS: Treatment of FL and DLBCL using SC rituximab can achieve cost-savings in Singapore, with a greater proportion of cost-savings being contributed by reductions in drug costs than in non-drug costs.

Conference/Value in Health Info

2018-09, ISPOR Asia Pacific 2018, Tokyo, Japan

Value in Health, Vol. 21, S2 (September 2018)

Code

PCN56

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Oncology

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