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Cost-Effectiveness of First-Line Zuberitamab-CHOP versus Rituximab-CHOP Regimens in Untreated CD20+ Diffuse Large
Lihong Gao1,2, Haomin Zhu1, Jia Wang3
1Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
Purpose:
To conduct a cost-effectiveness analysis comparing zuberitamab combined with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone; Hi-CHOP) versus rituximab combined with CHOP (R-CHOP) as first-line therapy for previously untreated CD20-positive diffuse large B-cell lymphoma (DLBCL) patients in China.
Patients And Methods:
A partitioned survival model (PSM) was developed to conduct a cost-effectiveness analysis of Hi-CHOP versus R-CHOP regimens in newly diagnosed CD20-positive DLBCL patients. The study utilized a 20-year time frame. Evaluated outcomes included overall survival (OS), quality-adjusted life-years (QALYs), total treatment costs, and incremental cost-effectiveness ratios (ICERs). The willingness-to-pay (WTP) threshold was defined as $40,334.05 per QALY, equivalent to triple China's 2024 per capita GDP.
Results:
The base-case analysis indicated that Hi-CHOP provided an additional 1.49 life-years and 1.57 QALYs compared to R-CHOP. The total treatment cost of Hi-CHOP was $238,164.77 higher than that of R-CHOP over 20 years, resulting in ICERs of $151,373.19 per QALY and $160,273.99 per life-year. One-way sensitivity analysis (OSA) identified progression-free survival (PFS) utility as the most significant parameter impacting model outcomes. Probabilistic sensitivity analysis (PSA) demonstrated that almost all simulated outcomes surpassed the WTP threshold. The cost-effectiveness acceptability curve (CEAC) demonstrated R-CHOP's superior cost-effectiveness probability relative to Hi-CHOP across a WTP range from $0 to $150,000.
Conclusion:
Given that Hi-CHOP is not cost-effective at conventional WTP thresholds, a substantial price reduction or unnecessary procedures, and optimizing clinical workflows for Hi-CHOP would be necessary to make it an economically viable first-line option for DLBCL compared to R-CHOP.
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