二线 Lisocabtagene Maraleucel 治疗复发/难治性大 B 细胞淋巴瘤的成本效果分析

CAR-T cell therapies such as lisocabtagene maraleucel (liso-cel) have transformed the treatment of patients with second line primary refractory or early relapsed 12 months (R/R) large B-cell lymphoma (LBCL). The objective of this study was to assess the cost-effectiveness of liso-cel compared to standard of care (SOC) to treat R/R LBCL in France.

A 3-health-state model was developed to compare liso-cel to SOC over 20 years in France. Efficacy and safety were extrapolated from the TRANSFORM trial (NCT03575351), or DESCAR-T (registry of patients treated with a CAR-T in France). Costs were calculated using French-specific sources. Outcomes were quality-adjusted life years (QALY), life-years (LY), total costs, incremental cost-utility and cost-effectiveness ratios (ICUR, ICER). Probabilistic sensitivity analysis (PSA) was conducted to assess the robustness of the results.

Liso-cel generated 5.7 QALY (6.4 LY) for a 265 907. SOC generated 4.4 QALY (5.1 LY) for 233 903. ICUR and ICER were estimated at 24 580/QALY and 23 464/LY gained versus SOC. PSA showed that liso-cel was more effective and more costly in 92% of the simulations.

Liso-cel is cost-effective versus SOC to treat R/R LBCL patients in France. Generation of long-term real-world data is needed in order to validate these findings.