Acalabrutinib is more cost-effective and associated with better clinical outcomes in patients with relapsed or refractory mantle cell lymphoma (MCL) compared with ibrutinib and zanubrutinib, according to an abstract presented at the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition.
This study was presented by Neda Alrawashdh, PharmD, Center for Health Outcomes and PharmacoEconomic Research, University of Arizona, Tucson.
First and second generation Bruton’s tyrosine kinase (BTK) inhibitors are associated with improvements in efficacy and safety compared with conventional chemotherapy, but direct comparisons of clinical trials between BTK inhibitors are lacking.
This study evaluated the cost-effectiveness of acalabrutinib compared to ibrutinib and zanubrutinib in the treatment of patients with relapsed/refractory MCL from a US payer perspective.
Existing evidence from 3 phase 1/2 clinical trials was used for this analysis. Cost and PFS life years (LYs) and PFS quality-adjusted LYs (QALYs) for each treatment, the incremental PFS LYs and PFS QALYs gained with acalabrutinib or zanubrutinib over ibrutinib, and the incremental cost-effectiveness ratio (ICER) and cost-utility ratio (ICUR) were estimated.
Incremental PFS LYs gained from acalabrutinib and zanubrutinib compared with ibrutinib were 1.61 and 0.98, and incremental PFS QALYs of 1.27 and 0.77, respectively. The ICERs and ICURs for acalabrutinib and zanubrutinib were lower than the US willingness to pay threshold of $100,000 to $150,000 per QALY for cancer treatment. Cost-effectiveness acceptability curves showed acalabrutinib having the highest probability of being cost-effective compared with zanubrutinib and ibrutinib.
“Acalabrutinib is more cost-effective compared with ibrutinib and zanubrutinib and improves health outcomes more in relapsed/refractory patients with MCL,” Dr Alrawashdh concluded her presentation.—Lisa Kuhns
Alrawashdh N, McBride A, Slack M, Abraham I. Economic Evaluation of Ibrutinib Versus Acalabrutinib Versus Zanubrutinib for Patients with Relapsed or Refractory Mantle Cell Lymphoma. Presented at: the 62nd ASH Annual Meeting and Exposition; Dec 5-8, 2020. Abstract 2506.
