US cost–effectiveness of polatuzumab vedotin, bendamustine and rituximab in diffuse large B-cell lymphoma
This article has been corrected.
VIEW CORRECTIONPublication: Journal of Comparative Effectiveness Research
Abstract
Aim: To evaluate the cost–effectiveness of polatuzumab vedotin (pola) + bendamustine + rituximab (BR) in relapsed/refractory diffuse large B-cell lymphoma based on the GO29365 trial from a US payer’s perspective. Materials & methods: A partitioned survival model used progression-free survival and overall survival data from the GO29365 trial. The base case analysis assumed overall survival was informed by progression-free survival; a mixture cure model estimated proportion of long-term survivors. Results: In the base case, pola + BR was cost-effective versus BR at US$35,864 per quality-adjusted life year gained. Probabilistic and one-way sensitivity analyses showed that the findings were robust. Conclusion: Pola + BR is cost-effective versus BR for the treatment of transplant-ineligible relapsed/refractory diffuse large B-cell lymphoma in the US.
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References
Papers of special note have been highlighted as: • of interest; •• of considerable interest
1.
National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines) B-Cell lymphomas. V4.2020. 1–297 (2020). https://www.nccn.org/professionals/physician_gls/pdf/b-cell.pdf
2.
National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results Program (SEER). Cancer stat facts: NHL - Diffuse large B-Cell lymphoma (DLBCL) 2019. (2019). https://seer.cancer.gov/statfacts/html/dlbcl.html
3.
Liu Y, Barta SK. Diffuse large B-cell lymphoma: 2019 update on diagnosis, risk stratification, and treatment. Am. J. Hematol. 94(5), 604–616 (2019).
• This review article provides an overview of diffuse large B-cell lymphoma (DLBCL), including current diagnosis, risk stratification and treatments. The focus is how cell-of-origin and molecular features are being used to guide treatment of front-line and relapsed/refractory DLBCL.
4.
Crump M, Kuruvilla J, Couban S et al. Randomized comparison of gemcitabine, dexamethasone, and cisplatin versus dexamethasone, cytarabine, and cisplatin chemotherapy before autologous stem-cell transplantation for relapsed and refractory aggressive lymphomas: NCIC-CTG LY.12. J. Clin. Oncol. 32(31), 3490–3496 (2014).
5.
Gisselbrecht C, Glass B, Mounier N et al. Salvage regimens with autologous transplantation for relapsed large B-cell lymphoma in the rituximab era. J. Clin. Oncol. 28(27), 4184–4190 (2010).
6.
Vacirca JL, Acs PI, Tabbara IA et al. Bendamustine combined with rituximab for patients with relapsed or refractory diffuse large B cell lymphoma. Ann. Hematol. 93(3), 403–409 (2014).
7.
van Den Neste E, Schmitz N, Mounier N et al. Outcome of patients with relapsed diffuse large B-cell lymphoma who fail second-line salvage regimens in the International CORAL study. Bone Marrow Transplant. 51(1), 51–57 (2016).
• This article reports updated outcomes of the Collaborative Trial in Relapsed Aggressive Lymphoma (CORAL) study, for patients who could not proceed to scheduled autologous stem cell transplantation (ASCT). Median overall survival was significantly improved for patients with lower tertiary IPI, those responding to third-line treatment, and those who were eventually transplanted.
8.
Crump M, Neelapu SS, Farooq U et al. Outcomes in refractory diffuse large B-cell lymphoma: results from the international SCHOLAR-1 study. Blood. 130(16), 1800–1808 (2017).
9.
Genentech, Inc. POLIVY™ (polatuzumab vedotin-piiq) for injection, for intravenous use. (2019). https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/761121s000lbl.pdf
10.
US FDA. FDA approves polatuzumab vedotin for diffuse large B-cell lymphoma 2019. (2019). https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-polatuzumab-vedotin-piiq-diffuse-large-b-cell-lymphoma
11.
Sehn LH, Herrera AF, Flowers CR et al. Polatuzumab vedotin in relapsed or refractory diffuse large B-cell lymphoma. J. Clin. Oncol. 38(2), 155–165 (2020).
• This original article reports on the Phase Ib/II trial of polatuzumab vedotin plus benamustine + obinutuzumab (BG), or polatuzumab vedotin plus bendamustine + rituximab (BR) versus BR alone in patients with transplant-ineligible relapsed/refractory DLBCL. Polatuzumab vedotin plus BR resulted in a significantly higher CR rate and reduced risk of death compared with BR alone.
12.
Sehn LH, Matasar MJ, Flowers CR et al. Polatuzumab vedotin plus bendamustine with rituximab in relapsed/refractory diffuse large B-cell lymphoma: updated results of a Phase Ib/II randomized study. Poster presented at ASH 2019 (P-4081) (2019).
• This poster reports the updated results of the Phase II trial of polatuzumab vedotin plus BR in relapsed/refractory DLBCL with an additional year of follow-up. No new safety signals were identified. Progression-free survival and overall survival remain significantly better for patients receiving polatuzumab vedotin plus BR versus BR, and 38% patients treated with polatuzumab vedotin plus BR had response durations ≥12 months.
13.
Sehn LH, Flowers CR, McMillan A et al. Estimation of long-term survival with polatuzumab vedotin plus bendamustine and rituximab for patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). Hematol. Oncol. 37(S2), 257–258 (2019).
14.
National Institute for Health and Care Excellence (NICE). Axicabtagene ciloleucel for treating diffuse large B-cell lymphoma and primary mediastinal large B-cell lymphoma after 2 or more systemic therapies (TA559). (2019). https://www.nice.org.uk/Guidance/TA559
15.
National Institute for Health and Care Excellence (NICE). Tisagenlecleucel for treating relapsed or refractory diffuse large B-cell lymphoma after 2 or more systemic therapies (TA567). (2019). https://www.nice.org.uk/Guidance/TA567
16.
Lambert PC. Modeling of the cure fraction in survival studies. Stata J. 7(3), 351–375 (2007).
17.
Bansal A, Sullivan SD, Lin VW et al. Estimating long-term survival for patients with relapsed or refractory large B-cell lymphoma treated with chimeric antigen receptor therapy: a comparison of standard and mixture cure models. Med. Decis. Making. 39(3), 294–298 (2019).
• This estimated long-term survival for patients with relapsed or refractory large B-cell lymphoma treated with chimeric antigen receptor therapy. Standard parametric models were compared with mixture cure models. Based on the findings, they suggest that mixture cure models may provide a more accurate estimate of long-term survival compared with standard models, with sufficient follow-up.
18.
Schuster SJ, Bishop MR, Tam CS et al. Tisagenlecleucel in adult relapsed or refractory diffuse large B-cell lymphoma. N. Engl. J. Med. 380(1), 45–56 (2019).
19.
United Kingdom National Institute for Health and Care Excellence. Single technology appraisal. Tisagenlecleucel-T for treating relapsed or refractory diffuse large B-cell lymphoma [ID 1166] 2018. (2019). https://www.nice.org.uk/guidance/ta567
20.
Rowen D, Brazier J, Roberts J. Mapping SF-36 onto the EQ-5D index: how reliable is the relationship? Health. Qual Life. Outcomes. 7(27), (2009).
21.
Genentech, Inc. Data on File.
22.
United States Centers for Medicare & Medicaid Services (CMS). ASP pricing file (effective 01/01/2019 - 03/31/2019). (2019). https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/2019ASPFiles.html
23.
United States Centers for Medicare & Medicaid Services (CMS). Physician fee schedule search. (2019). https://www.cms.gov/apps/physician-fee-schedule/overview.aspx
24.
United States Centers for Medicare & Medicaid Services (CMS). Clinical Laboratory Fee Schedule (CLFS) public use file (Updated 01/15/19). (2019). https://www.cms.gov/Medicare/Medicare-Fee-for-ServicePayment/ClinicalLabFeeSched/Clinical-Laboratory-Fee-Schedule-Files.html
25.
Huntington S, Keshishian A, McGuire M et al. Costs of relapsed diffuse large B-cell lymphoma among Medicare patients. Leuk. Lymphoma. 59(12), 2880–2887 (2018).
• This observational study used Medicare claims to analyze the variation in health care costs for patients with diffuse large B-cell lymphoma treated in front-line and the relapsed settings. The results confirmed that older adults with relapsed diffuse large B-cell lymphoma incur higher medical costs, and suggest improving front-line treatment would reduce likelihood of relapse, but would contain health care costs.
26.
Chastek B, Harley C, Kallich J et al. Health care costs for patients with cancer at the end of life. J. Oncol. Pract. 8(6), 75s–80s (2012).
27.
Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project (HCUP). 2015 HCUPnet (2019). https://hcupnet.ahrq.gov/#setup
28.
United States Bureau of Labor Statistics. Consumer price index – all urban consumers medical care in U.S. city average, all urban consumers, not seasonally adjusted . (2019). https://data.bls.gov/timeseries/CUUR0000SAM
29.
Genentech, Inc. RITUXAN® (rituximab) highlights of prescribing information. (2019). https://www.gene.com/download/pdf/rituxan_prescribing.pdf
30.
Teva Pharmaceuticals USA, Inc. BENDEKA® (bendamustine hydrochloride injection) highlights of prescribing information. (2018). https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/208194s000lbl.pdf
31.
Institute for Clinical and Economic Review (ICER). Overview of the ICER assessment framework and update for 2017–2019. (2019). https://icer-review.org/wp-content/uploads/2018/03/ICER-value-assessment-framework-update-FINAL-062217.pdf
32.
Neelapu SS, Locke FL, Bartlett NL et al. Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-cell lymphoma. N. Engl. J. Med. 377(26), 2531–2544 (2017).
33.
Lin JK, Muffly LS, Spinner MA et al. Cost effectiveness of chimeric antigen receptor T-cell therapy in multiply relapsed or refractory adult large B-cell lymphoma. J. Clin. Oncol. 37(24), 2105–2119 (2019).
34.
Whittington MD, McQueen RB, Ollendorf DA et al. Long-term survival and cost–effectiveness associated with axicabtagene ciloleucel vs chemotherapy for treatment of B-cell lymphoma. JAMA Netw Open. 2(2), e190035 (2019).
35.
Roth JA, Sullivan SD, Lin VW et al. Cost–effectiveness of axicabtagene ciloleucel for adult patients with relapsed or refractory large B-cell lymphoma in the United States. J. Med. Econ. 21(12), 1238–1245 (2018).
36.
Tully S, Feng Z, Grindrod K et al. Developing a discrete-event simulation to study the influence of waiting times on the effectiveness and cost–effectiveness of chimeric antigen receptor (CAR) T-cell therapy in large B-cell lymphoma. Value. In. Health. 22(S521), (2019).
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Pages: 1003 - 1015
PubMed: 33028076
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© 2020 Keith A Betts et al. This work is licensed under the Attribution-NonCommercial-NoDerivatives 4.0 Unported License
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Received: 9 April 2020
Accepted: 18 August 2020
Published online: 8 October 2020
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US cost–effectiveness of polatuzumab vedotin, bendamustine and rituximab in diffuse large B-cell lymphoma. (2020) Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2020-0057
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