Abstract：
OBJECTIVE: Novel interventions (axicabtagene ciloleucel [axi-cel], lisocabtagene maraleucel [liso-cel], tafasitamab-lenalidomide [Tafa-L], polatuzumab-rituximab-bendamustine [pola-BR]) improve clinical outcomes in second-line (2 L) treatment of transplant-ineligible patients with early relapse or refractory (R/R) diffuse large B cell lymphoma (DLBCL). The costs vary depending on the respective treatment regimen and the treatment duration, difficult comparability in reimbursement decisions. The objective was to analyze the health economic impacts of novel 2 L interventions and conventional immunochemotherapies (bendamustine-rituximab [BR], rituximab-gemcitabine-oxaliplatin [R-GemOx]) from a German healthcare payer\'s perspective as a function of treatment duration.
METHODS: An economic model was developed to compare treatment costs of 2 L interventions depending on the treatment duration. Treatment duration was measured by progression-free survival (PFS), identified based on a systematic review. Total and average costs were calculated over 5 years to evaluate incremental costs at median PFS for each intervention.
RESULTS: Average costs per month at median PFS ranged from €2846 (95% CI: 5067-1641) to €40 535 (95% CI: 91180-N/A) for BR and liso-cel, respectively. Incremental costs at the lowest median PFS (R-GemOx: 5.3 months) revealed -€664, €5560, €11 817, €53 145, and €67 745 for BR, Tafa-L, pola-BR, axi-cel, and liso-cel as compared to R-GemOx, respectively.
CONCLUSIONS: Analyses uncovered a variation of incremental costs of 2 L transplant-ineligible DLBCL interventions as a function of time leading to amortization of high-priced interventions.
METHODS: An economic model was developed to compare treatment costs of 2 L interventions depending on the treatment duration. Treatment duration was measured by progression-free survival (PFS), identified based on a systematic review. Total and average costs were calculated over 5 years to evaluate incremental costs at median PFS for each intervention.
RESULTS: Average costs per month at median PFS ranged from €2846 (95% CI: 5067-1641) to €40 535 (95% CI: 91180-N/A) for BR and liso-cel, respectively. Incremental costs at the lowest median PFS (R-GemOx: 5.3 months) revealed -€664, €5560, €11 817, €53 145, and €67 745 for BR, Tafa-L, pola-BR, axi-cel, and liso-cel as compared to R-GemOx, respectively.
CONCLUSIONS: Analyses uncovered a variation of incremental costs of 2 L transplant-ineligible DLBCL interventions as a function of time leading to amortization of high-priced interventions.
摘要：
目的：新型干预措施（axicabtageneciloleucel[axi-cel]，lisocabtagenemaraleucel[liso-cel]，他法他单抗-来那度胺[Tafa-L]，polatuzumab-利妥昔单抗-苯达莫司汀[pola-BR])可改善早期复发或难治性(R/R)弥漫性大B细胞淋巴瘤(DLBCL)患者二线(2L)治疗的临床结局.费用因各自的治疗方案和治疗持续时间而异，报销决定中的难以比较。目的是分析新型2L干预措施和常规免疫化疗（苯达莫司汀-利妥昔单抗[BR]，利妥昔单抗-吉西他滨-奥沙利铂[R-GemOx]）从德国医疗保健提供者的角度作为治疗持续时间的函数。
方法：开发了一种经济模型，以根据治疗持续时间比较2L干预措施的治疗费用。治疗持续时间通过无进展生存期（PFS）来衡量，根据系统审查确定。计算了5年内的总成本和平均成本，以评估每个干预措施在平均PFS时的增量成本。
结果：BR和Liso-cel的平均PFS每月平均成本为2846欧元（95％CI：5067-1641）至40535欧元（95％CI：91180-N/A），分别。最低平均PFS（R-GemOx：5.3个月）的增量成本显示-BR664欧元，5560欧元，11817欧元，53145欧元和67745欧元，Tafa-L,pola-BR,axi-cel,与R-GemOx相比，分别。
结论：分析揭示了2L移植不合格的DLBCL干预措施的增量成本随时间的变化，导致高价干预措施的摊销。
方法：开发了一种经济模型，以根据治疗持续时间比较2L干预措施的治疗费用。治疗持续时间通过无进展生存期（PFS）来衡量，根据系统审查确定。计算了5年内的总成本和平均成本，以评估每个干预措施在平均PFS时的增量成本。
结果：BR和Liso-cel的平均PFS每月平均成本为2846欧元（95％CI：5067-1641）至40535欧元（95％CI：91180-N/A），分别。最低平均PFS（R-GemOx：5.3个月）的增量成本显示-BR664欧元，5560欧元，11817欧元，53145欧元和67745欧元，Tafa-L,pola-BR,axi-cel,与R-GemOx相比，分别。
结论：分析揭示了2L移植不合格的DLBCL干预措施的增量成本随时间的变化，导致高价干预措施的摊销。
