TY  - JOUR
AU  - Kurte, Melina Sophie
AU  - Siefen, Ann-Cathrine
AU  - Jakobs, Florian
AU  - von Tresckow, Bastian
AU  - Reinhardt, Hans Christian
AU  - Kron, Florian
TI  - Cost-effectiveness analysis of transplant-ineligible relapsed or refractory diffuse large B-cell lymphoma treatment options-Experience of the efficiency frontier approach.
JO  - European journal of haematology
VL  - 111
IS  - 6
SN  - 0902-4441
CY  - Oxford
PB  - Wiley-Blackwell
M1  - DKFZ-2023-01756
SP  - 895-908
PY  - 2023
N1  - 2023 Dec;111(6):895-908
AB  - The treatment of relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) changed remarkably since the European Medicines Agency-approved chimeric antigen receptor T-cell (CAR-T) therapies (axicabtagene ciloleucel [axi-cel], lisocabtagene maraleucel [liso-cel], tisagenlecleucel [tisa-cel]) for the third-line onwards (3+L), and targeted therapies (polatuzumab vedotin-bendamustine-rituximab [pola-BR], tafasitamab-lenalidomide [Tafa-L]) for the second-line (2L) onwards. As associated rising treatment costs represent an economic burden, the cost-effectiveness of transplant-ineligible R/R DLBCL interventions was assessed from a German healthcare payer's perspective, using the efficiency frontier (EF) approach.A systematic literature review was performed to determine the clinical benefit concerning median overall survival (OS) of bendamustine-rituximab (BR), rituximab-gemcitabine-oxaliplatin (R-GemOx), axi-cel, liso-cel, tisa-cel, pola-BR, and Tafa-L. First-year treatment costs (drug and medical services costs) were calculated. Results were merged on two-dimensional graphs illustrating 2L and 3+L EFs.Second-line EF is formed by BR (median OS 11.49 months, €23 958) and Tafa-L (45.7, €104 541), 3+L EF is formed by R-GemOx (12.0, €29 080), Tafa-L (15.5, €104 541), and axi-cel (18.69, €308 516). These interventions build the respective cost-effectiveness thresholds for novel interventions.Using the EF approach, the currently most cost-effective interventions (based on cost-effectiveness ratios) in the indication of R/R DLBCL were identified to guide international reimbursement decisions.
KW  - CAR-T-cell therapy (Other)
KW  - DLBCL (Other)
KW  - cost-effectiveness (Other)
KW  - diffuse large B-cell lymphoma (Other)
KW  - efficiency frontier (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:37644352
DO  - DOI:10.1111/ejh.14095
UR  - https://inrepo02.dkfz.de/record/282429
ER  -