Cost Burden Linked With CAR-T Therapy for R/R DLBCL

Patients with relapsed or refractory diffuse large B-cell lymphoma (r/r DLBCL) who received tisagenlecleucel had lower rates of adverse events and health care resource use, and subsequently lower associated cost burdens, than those who received axicabtagene ciloleucel, according to an abstract presented at the 2021 ASCO Annual Meeting.

The study summarized data from four real-world trials that reported rates of adverse events and health care resource use associated with the two chimeric antigen receptor T-cell (CAR-T) therapies.

Across all four studies, rates of grade 3 or higher cytokine release syndrome and neurotoxicity events ranged between 1% and 4% and 0% and 5%, respectively, with tisagenlecleucel, compared with between 7% and 16%, and 20% and 35%, with axicabtagene ciloleucel, researchers reported.

Tocilizumab use occurred in 14% to 20% of patients treated with tisagenlecleucel compared with 62% to 71% of patients treated with axicabtagene ciloleucel. Although CAR-T infusion was inpatient for 36% of patients receiving tisagenlecleucel, between 92% and 100% of patients receiving axicabtagene ciloleucel had inpatient infusion.

Median hospitalization was 2 days with tisagenlecleucel compared with between 15 days and 16 days with axicabtagene ciloleucel. Seven percent of patients treated with tisagenlecleucel underwent intensive care unit (ICU) transfer, while ICU transfer rates with axicabtagene ciloleucel were between 28% and 38%; median ICU stays were 4 days with tisagenlecleucel and 5 days with axicabtagene ciloleucel.

Researchers estimated total per-patient costs of managing adverse events were between $843 and $1962 with tisagenlecleucel and between $5,979 and $10,878 for axicabtagene ciloleucel. Meanwhile, total health care resource use costs per patients were an estimated $3321 with tisagenlecleucel, compared with between $32,394 and $33,166 for axicabtagene ciloleucel.

“The additional cost burden for [axicabtagene ciloleucel] was primarily driven by the incremental ICU and hospitalization care due to a higher proportion of inpatient infusion among patients receiving [axicabtagene ciloleucel],” researchers advised.

“Further research is warranted to compare the costs associated with the two CAR-Ts in r/r DLBCL.”

Reference:
Yang H, Zhengyun Qi C, Dalal A, et al. Estimating costs of adverse events (AEs) and healthcare resource use (HRU) in patients with relapsed or refractory diffuse large B-cell lymphoma (r/r DLBCL) receiving tisagenlecleucel (tisa-cel) and axicabtagene ciloleucel (axi-cel): a summary of real-world evidence. Abstract presented at 2021 ASCO Annual Meeting; June 4-8, 2021.