Polatuzumab vedotin plus bendamustine-rituximab is cost-effective in comparison to bendamustine-rituximab alone for the treatment of adult patients with transplant ineligible, relapsed/refractory diffuse large B-cell lymphoma (DLBCL) in the US, according to a study presented at the virtual 62nd ASH Annual Meeting and Exposition.
“Polatuzumab vedotin plus bendamustine-rituximab is approved by the FDA for the treatment of relapsed refractory DLBCL after at least 2 prior therapies based on a randomized phase 2 trial. A recent cost effectiveness analysis found that polatuzumab vedotin plus bendamustine-rituximab is likely to be cost effective compared with bendamustine-rituximab alone for relapsed/refractory DLBCL,” said Keith Betts, Analysis Group, Los Angeles, California, during his poster presentation.
This study evaluated the cost-effectiveness of polatuzumab vedotin plus bendamustine-rituximab in DLBCL from a US payer’s perspective.
Researchers developed a partitioned survival model to estimate the economic and health-related quality of life (HRQoL) impact of polatuzumab vedotin plus bendamustine-rituximab versus bendamustine-rituximab alone in transplant-ineligible patients with relapsed/refractory DLBCL.
The total cost of polatuzumab vedotin plus bendamustine-rituximab was $210,418 compared to $118,089 for bendamustine-rituximab alone. The higher total cost of polatuzumab-vedotin plus bendamustine-rituximab were primarily due to higher drug and administration costs ($139,717 vs $47944, respectively).
Polatuzumab vedotin plus bendamustine-rituximab had higher costs due to adverse events management ($21,989) than bendamustine rituximab alone ($15,505). However, polatuzumab vedotin plus bendamustine rituximab demonstrated cost savings for progressive disease care (-$4849) and end-of-life care (-$2248) in comparison to bendamustine-rituximab alone.
Polatuzumab vedotin plus bendamustine-rituximab was associated with an additional 2.57 QALYs compared to bendamustine-rituximab alone. The incremental cost-effectiveness ratio (ICER) was $35,864 per QALY gained.
Probabilistic sensitivity analyses demonstrated that polatuzumab vedotin plus bendamustine-rituximab was cost-effect in comparison to bendamustine-rituximab alone in 68% and 97% of cases using a willingness-to-pay threshold of $50,000 and $100,000, respectively.
“In conclusion, driven predominantly by higher progression free survival and overall survival as well as the higher estimated proportion of long-term survivors, the results of this cost-effectiveness analysis suggest that in the US polatuzumab vedotin plus bendamustine-rituximab is cost effective compared to bendamustine-rituximab alone for the treatment of adults with transplant ineligible relapsed refractory DLBCL,” concluded Mr Betts.
Betts K, Felizzi F, Dieye I, et al. Cost-Effectiveness of Polatuzumab Vedotin Plus Bendamustine-Rituximab for Transplant-Ineligible Relapsed/Refractory Diffuse Large B-Cell Lymphoma in the United States. Presented at: the virtual 62nd ASH Annual Meeting and Exposition; December 5-8, 2020. Abstract 1602.
