Economic evaluation of plerixafor for stem cell mobilization

Area of Science:

• Hematology
• Oncology
• Health Economics

Background:

• Autologous peripheral stem cell transplantation (ASCT) is a key treatment for relapsed non-Hodgkin lymphoma (NHL).
• Current stem cell mobilization (SCM) regimens have failure rates between 5% and 30%.
• Granulocyte colony-stimulating factor (G-CSF) combined with plerixafor (G+P) shows superiority over G-CSF alone for SCM in heavily pretreated NHL patients.

Purpose of the Study:

• To evaluate the cost-utility of G+P compared to G-CSF for SCM in diffuse large B-cell lymphoma (DLBCL) patients undergoing ASCT.
• DLBCL is the most common subtype of NHL, making this a relevant patient population.

Main Methods:

• A Markov model simulated patient care pathways for DLBCL patients undergoing ASCT.
• Data were sourced from the plerixafor phase III study and relevant literature.
• Microsimulation was used to estimate the incremental cost-utility ratio (ICUR) over a patient's lifetime.

Main Results:

• The G+P regimen resulted in an additional $25,567 in lifetime costs compared to G-CSF.
• Patients receiving G+P gained an average of 1.74 quality-adjusted life-years (QALYs).
• The ICUR was calculated at $14,735 per QALY, demonstrating robustness in sensitivity analyses.

Conclusions:

• The G+P regimen for SCM in ASCT for DLBCL patients meets accepted cost-effectiveness standards.
• The improved effectiveness of G+P in stem cell mobilization drives its favorable cost-utility profile.