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Cost-Effectiveness of KTE-X19 vs Standard of Care for Relapsed/Refractory MCL

March 16, 2021

KTE-X19 is a potentially cost-effective alternative to the current standard of care for relapsed/refractory mantle cell lymphoma (MCL), according to a study in the Journal of Medical Economics (2021;1. doi: 10.1080/13696998.2021.1894158).

This study aimed to estimate the cost-effectiveness of KTE-X19 vs the current standard of care for relapsed/refractory MCL from a US health care perspective.

Researchers used a 3-state partitioned-survival model (pre-progression, post-progression, and death) with a cycle length of 1 month to estimate progression-free survival (PFS) and overall survival (OS) over a lifetime horizon.

Population inputs, KTE-X19 efficacy and safety data, and health state utilities were derived from the ZUMA-2 trial. Efficacy and safety data for the standard of care, costs and resource inputs, and adverse event disutilities were derived from the published literature and publicly available data sources.

Costs and health outcomes were discounted at 3% per year. The model estimated expected life-years (LYs), Quality-adjusted life-years and total costs for KTE-X19 vs standard of care.

Median survival with KTE-X19 was 9.71 years compared with 2.13 years for standard of care. Discounted LYs, QALYs, and lifetime costs were 8.99, 7.39, and $93,832 for KTE-X19 compared with 4.47, 3.65, and $574,263 for standard of care, respectively.

In addition, the difference in cost per QALY for KTE-X19 vs standard of care was $31,985.

“The most influential model parameter was the utility for patients with long-term remission,” wrote Claire L Simons, PhD, MSc, Pharmerit—an Open Health Company, York, UK, and colleagues.

At a willingness-to-pay threshold of $150,000 per QALY, the probability that KTE-X19 was cost-effective for relapsed/refractory MCL was 99%.

“The treatment of [relapsed/refractory] MCL with KTE-X19 presents a potentially cost-effective alternative to the current [standard of care], deriving its value from incremental survival and health-related quality of life benefits,” Ms Simons and colleagues concluded.—Janelle Bradley

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