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Abstract
Brexucabtagene autoleucel is a chimeric anti CD19 antigen receptor T-cell therapy that allows durable responses in relapsed/refractory (R/R) mantle cell lymphoma (MCL). The present study compared the clinical and economic outcomes of R/R MCL patients (pre-exposed to ibrutinib and chemoimmunotherapy) treated with brexucabtagene autoleucel versus Rituximab, bendamustine, cytarabine (R-BAC) in the Italian Healthcare System. A partitioned-survival model extrapolated survival and healthcare costs of R/R MCL patients over a lifetime horizon. Discounted and quality-adjusted life expectancy (QALY) was 6.40 versus 1.20 for brexucabtagene autoleucel versus R-BAC and lifetime costs were €411,403 versus €74,415, respectively, which corresponds to a cost of €64,798 per QALY gained. The results were highly sensitive to brexucabtagene autoleucel acquisition cost and to assumptions on long-term survival, therefore the cost-effectiveness of brexucabtagene autoleucel for patients with R/R MCL requires validation with longer follow-up data and in specific risk subgroups.
Acknowledgments
The decision model has been developed by PharmaMerit.
The authors thank Sara Mollea (Gilead Sciences srl), Elisa Martelli (Gilead Sciences srl), and Gab Castaigne for the precious clarifications concerning the design of the economic model and the patient population involved.
Authors’ contribution
Monia Marchetti implemented the decision model, conducted the analysis and drafted the manuscript. Carlo Visco checked the model inputs and revised the manuscript.
Disclosure statement
The authors received consultancy fees from Gilead Sciences S.r.l. The view expressed by the authors does not represent and has not to be interpreted as the views of the Institutions they are affiliated to.