复发/难治性弥漫大 B 细胞淋巴瘤患者管理中的医疗资源使用——加拿大视角

Aim: Epcoritamab, the first subcutaneous (SC) bispecific approved for relapsed/refractory diffuse large B-cell lymphoma (R/R-DLBCL), offers potential advantages in terms of healthcare resource utilization (HCRU) associated with its SC administration.

This study aimed to estimate HCRU and associated costs of R/R-DLBCL treatments, to inform health technology assessment agencies, institutional decision makers and healthcare professionals (HCP) from both a Canadian and Quebec perspective. Secondary objectives included using a societal perspective and estimating chair time and HCP time involved in administering treatments. Materials & methods: A 1-year costing analysis was developed comparing epcoritamab to other R/R-DLBCL treatments, including glofitamab, CAR-T cell therapies, chemotherapy, Pola-BR and Tafa-Len. HCRU and associated costs included pretreatment, administration, monitoring, and adverse event management. Acquisition costs of active treatments were excluded. Multiple time horizons were assessed. Model inputs were retrieved from product labels and validated by clinical experts to reflect practice. Results: From the Canadian and Quebec healthcare system perspective, total 1-year HCRU costs ranged from $11,009 to $54,946 and $10,041 to $54,362, respectively.

Epcoritamab ranked as the second least costly comparator after chemotherapy, with notable HCRU savings driven by low administration costs of SC injections and adverse event management costs. Epcoritamab ranked similarly from a societal perspective and scenario analysis evaluating a 2-year time-horizon. Epcoritamab had the lowest annual chair time and HCP time, freeing up resources and HCP availability.

Conclusion: Considering the highly constrained Canadian healthcare system, SC epcoritamab offers substantial HCRU-related cost saving, chair time savings and HCP time savings when compared with other available treatments, making it an effective, efficient and patient-centric treatment option for R/R-DLBCL in Canada. What is this article about?

Treatments for relapsed/refractory diffuse large B-cell lymphoma (R/R-DLBCL) include a wide array of therapies, each with their own dosing schedules, methods of administration, adverse event rates and monitoring requirements. Epcoritamab, the first subcutaneous (SC) treatment for R/R-DLBCL, has recently received marketing authorization from Health Canada.

However, to date, no study has assessed the healthcare resources utilization and associated costs of a novel therapy like epcoritamab versus other R/R-DLBCL treatments. Given the crisis surrounding Canada's healthcare system and workforce, it is imperative to optimize treatment management to alleviate the strain on the healthcare system.

Therefore, we performed this research to assess the healthcare resources utilization and associated costs of epcoritamab versus other R/R-DLBCL treatments, to better understand the impact of these treatments on the healthcare system. What were the results? From both the Canadian and Quebec healthcare system perspective, epcoritamab was found to be the second least costly treatment option compared with other current and novel treatments for R/R-DLBCL.

Epcoritamab was also assessed as the treatment with the least total chair time and healthcare personnel time, due to its SC mode of administration. What do the results mean? The healthcare resources saved with SC epcoritamab compared with other treatments in R/R-DLBCL could help alleviate the strain on the Canadian healthcare system. This could allow resources to be redirected to other institutional priorities, and thereby enhance the accessibility and standard of healthcare services provided to Canadian patients.