Cost-effectiveness for KTE-X19 CAR T therapy for adult patients with relapsed/refractory mantle cell lymphoma in the United States
Autor: | Daniel C. Malone, Michael Wang, Craig Bennison, Gregory A. Maglinte, Tim Inocencio, Claire L. Simons, Bijal Shah, Sally W. Wade |
---|---|
Rok vydání: | 2021 |
Předmět: |
Adult
Oncology medicine.medical_specialty Standard of care Cost effectiveness Cost-Benefit Analysis Lymphoma Mantle-Cell Immunotherapy Adoptive 03 medical and health sciences 0302 clinical medicine Refractory immune system diseases hemic and lymphatic diseases Internal medicine medicine Humans Receptors Chimeric Antigen Adult patients business.industry 030503 health policy & services Health Policy medicine.disease United States 030220 oncology & carcinogenesis Relapsed refractory Mantle cell lymphoma Quality-Adjusted Life Years Neoplasm Recurrence Local Car t cells 0305 other medical science business |
DOI: | 10.6084/m9.figshare.14124270.v1 |
Popis: | The objective of this study is to estimate the cost-effectiveness of KTE-X19 versus standard of care (SoC) in the treatment of relapsed/refractory (R/R) mantle cell lymphoma (MCL) patients from a US healthcare perspective. A three-state partitioned-survival model (pre-progression, post-progression, and death) with a cycle length of 1 month was used to extrapolate progression-free and overall survival (OS) over a lifetime horizon. Due to the long tail of the OS curve, OS was modeled applying a mixture–cure methodology, using the assumption that patients whose disease had not progressed after 5 years experienced long-term remission. Population inputs were derived from the ZUMA-2 trial. This was also the source of KTE-X19 efficacy and safety data, while this data was obtained from the literature for SoC. Costs and resource use inputs were derived from the published literature and publicly available data sources. Health state utilities were derived from the ZUMA-2 trial (NCT02601313), applying the US tariff. Adverse event disutilities were derived from the published literature. Costs and health outcomes were discounted at 3% per year. The model estimated expected life years (LY), quality-adjusted life years (QALY), and total costs for KTE-X19 vs SoC. Deterministic and probabilistic sensitivity analyses were performed. Median survival was 9.71 years for KTE-X19 and 2.13 for SoC. Discounted LYs, QALYs, and lifetime costs were 8.99, 7.39, and $693,832 for KTE-X19 vs 4.47, 3.65, and $574,263 for SoC, respectively. The KTE-X19 vs SoC cost per QALY was $31,985. The most influential model parameter was the utility for patients with long-term remission. At a willingness-to-pay threshold of $150,000 per QALY, the probability that KTE-X19 was cost-effective was 99%. The treatment of R/R MCL with KTE-X19 presents a potentially cost-effective alternative to the current SoC, deriving its value from incremental survival and health-related quality-of-life benefits. |
Databáze: | OpenAIRE |
Externí odkaz: |