Correction

This article refers to:

Practice efficiency and total cost of care with bispecifics and CAR-T in relapsed/refractory diffuse large B-cell lymphoma: an institutional perspective1

Article title: Practice efficiency and total cost of care with bispecifics and CAR-T in relapsed/refractory diffuse large B-cell lymphoma: an institutional perspective

Authors: Lei, M., Li, Q., O'Day, K., Meyer, K., & Jun, M.

Journal: Future Oncology

DOI: https://dx.doi.org/10.1080/14796694.2024.2354157

In Table 1 an additional footnote has been inserted relating to the heading ‘Epcoritamab’ the added footnote reads ‘Grade 3/4 CRS was rounded to 3.0% and Grade 3+ ICANS was rounded to 1.0% in model calculations’.

The Grade 3/4 value for Epcoritamab within the ‘CRS’ section of the table has been updated to ‘2.5%’ from ‘3%’ to accurately reflect the rate in the product prescribing information.

Furthermore the ‘Grade 3/4’ subcategory within the ‘ICANS’ section has been changed to ‘Grade 3+’ based on the fact that the only non-Grade 1/2 ICANS event was Grade 5 according to the product prescribing information.

The ‘Epcoritamab’ value for this subcategory (Grade 3+, see previous point) has been changed to ‘0.6%’ from ‘1%’ to accurately reflect the rate in the product prescribing information.

The figure captions for Figures 2 and 3 were mistakenly switched, the caption for Figure 2 related to Figure 3 and vice versa. This has now been rectified.

Corrections

Table 1. Model inputs and sources.

Parameter	Value	Source
Medication costs
Dexamethasone, iv.	$0.12/mg	^21
Methylprednisolone, iv.	$12.03/80 mg	^21
Prednisone, PO	$0.05/5 mg	^21
Acetaminophen, PO	$0.03/500 mg	^22
Diphenhydramine, PO/IV	$0.02/50 mg PO, $1.07/50 mg IV	^21,22
Obinutuzumab, iv.	$7,775.32/1000 mg	^23
Zofran,† PO	$38.74/8 mg	^23
Fludarabine, iv.	$108.75/50 mg	^23
Cyclophosphamide, iv.	$338.89/500 mg	^23
Epcoritamab, SC	$1,268.8/4 mg, $15,225.56/48 mg	^23
Glofitamab, iv.	$2,554.74/2.5 mg, $10,218.98/10 mg	^23
Axicabtagene, iv.	$424,000 per infusion bag	^23
Polatuzumab vedotin, iv.	$16,550.04/140 mg	^23
Rituximab, iv.	$939.52/100 mg	^23
AE cost per event
CRS, grade 1	$13,584	^21,24–27
CRS, grade 2	$23,763
CRS, grade 3/4	$60,703
ICANS, grade 1 ^§	$0
ICANS, grade 2	$31,151
ICANS, grade 3/4	$22,973
Anemia, grade 3/4	$16,032
Neutropenia, grade 3/4	$22,365
Thrombocytopenia, grade 3/4	$21,428
Infection, grade 3/4	$10,873
Febrile neutropenia, grade 3/4	$22,365
Lymphopenia, grade 3/4	$22,365
Personnel hourly wage
Pharmacy technician	$19.9	^28
Pharmacist	$64.1
Registered nurse	$44.1
Fringe benefit rate	41.6%	^29
Blood test reimbursement
Complete blood cell count	$8.6	^30
Comprehensive metabolic panel	$11.7
Coagulation profiling	$6.7
Reimbursement/cost ratio	0.87	^31
% staff effort during infusion	64%	^32
% staff effort during inpatient monitoring	25%	Assumption based on clinical KOL opinion
Input—AE rates by treatment^8,9,20
AEs	Epcoritamab^¶	Glofitamab	Axi-cel
CRS
Grade 1	37.0%	52.0%	40.5%
Grade 2	17.0%	14.0%	40.5%
Grade 3/4	2.5%	4.1%	13.0%
ICANS
Grade 1	4.5%	2.4%	28.0%
Grade 2	1.3%	0.8%	28.0%
Grade 3+	0.6%	1.6%	31.0%
Other grade 3/4 events
Anemia	12.0%	8.0%	60.0%
Neutropenia	32.0%	26.0%	92.0%
Thrombocytopenia	12.0%	8.0%	56.0%
Infection	15.0%	10.0%	17.0%
Febrile neutropenia	3.0%	3.4%	31.0%
Lymphopenia	77.0%	83.0%	96.0%
Input: Staff and chair time per dose of treatment (in minutes)^‡^,^33–39
	Epcoritamab	Glofitamab	Axi-cel
Pre-treatment
Staff	–	304^#	–
Chair	–	390^#	–
Blood work
Staff	11	11	22
Chair	0	0	0
Premedication (or collection/bridging/conditioning for axi-cel)
Staff	52	60	871
Chair	98	107	1,129
Treatment administration
Staff	44	164	64
Chair	33	210	64

† Branded form of ondansetron. If using generic ondansetron, total cost for axi-cel will be lowered by $194 over the 1-year time horizon.

‡ Assumptions based on clinical KOL opinion.

§ Cost for ICANS was based on resource use in Abramson et al. 2021 and the unit costs of resources. The utilization of resources for an ICANS grade 1 event was reported as $0.

¶ Grade 3/4 CRS was rounded to 3.0% and Grade 3+ ICANS was rounded to 1.0% in model calculations.

# Pre-treatment staff and chair time for glofitamab were due to the requirement for pre-treatment with obinutuzumab.

AE: Adverse event; Axi-cel: Axicabtagene ciloleucel; CRS: Cytokine release syndrome; ICANS: Immune effector cell-associated-neurotoxicity syndrome; iv.: Intravenous; KOL: Key opinion leader; PO: By mouth; SC: Subcutaneous.

Figure 2. Total cost breakdown over each time horizon.

a Note: When examining costs over median duration of treatment, total costs were lower for glofitamab, while monthly costs were lower for epcoritamab.

Figure 3. Per-patient personnel and chair time of comparators vs epcoritamab. (A) 1-year time horizon. (B) 6-month time horizon. (C) Median cycles time horizon.