Obinutuzumab plus chemotherapy followed by obinutuzumab monotherapy is cost-effective vs. rituximab plus chemotherapy followed by rituximab monotherapy for previously untreated follicular lymphoma patients in the United States

Abstract

The GALLIUM trial compared obinutuzumab (GA101, G)-based chemotherapy followed by G monotherapy (G + chemo) for up to two years to rituximab (R)-based chemotherapy followed by R monotherapy (R + chemo) for up to two years in previously untreated follicular lymphoma (FL) patients. We estimated the cost-effectiveness of G + chemo versus R + chemo utilizing GALLIUM trial data and published literature. G + chemo had increased drug costs (undiscounted: $135,200 versus $127,700 for R + chemo), representing a relative increase of 5.9%. However, this was offset by a $6,400 lower cost for disease progression. G + chemo led to increased quality-adjusted life years (QALYs) relative to R + chemo of 0.81 (95% credible range, [CR]: 0.22–1.37), and the overall discounted incremental cost was $1,900 (95% CR: −$7,400 to $8,900). The incremental cost-effectiveness ratio was ∼$2,300 per QALY gained, and the results were highly robust to sensitivity analyses. Treatment with G + chemo compared to R + chemo is cost-effective in previously untreated FL patients in the US.

Keywords:

• Obinutuzumab
• follicular lymphoma
• rituximab
• decision model
• cost-effectiveness
• economic

Acknowledgements

The authors would like to acknowledge Tania Krivasi, Health Economics Group Manager, and Aino Launonen, HTA Statistician, both employees of F. Hoffmann-La Roche Ltd.

Potential conflict of interest:

Disclosure forms provided by the authors are available with the full text of this article online at http:\\<10.1080/10428194.2018.1551532>

Additional information

Funding

The economic analysis was sponsored by Genentech, Inc.