Health state utilities for relapsed or refractory large B-cell lymphoma treatments: a time trade-off study in the...

Conventional therapies in Japan for relapsed or refractory large B-cell lymphoma (r/r LBCL) require intravenous infusion (IV), while epcoritamab is administered subcutaneously. Despite the expected quality of life (QOL) improvement from reduced drug administration burden, limited data exists on QOL for common r/r LBCL treatment modalities. This study aimed to estimate the impact of drug administration on QOL (i.e. process utility) across treatments for r/r LBCL using responses from the Japanese general population.

An in-person questionnaire survey using the vignette-based time trade-off method was conducted. Participants from the Japanese general population, aged 20 years or older who were residing in Japan at the time of screening, valued vignettes representing therapy routes and schedules of epcoritamab monotherapy, salvage chemotherapy (R-ICE and Pola-BR as representatives) or no treatment. These vignettes were developed based on previous studies, clinical trial data, and expert opinions. Descriptive statistics were calculated for each vignette's utility values and the differences in utility between vignettes.

The survey included 308 participants (mean age: 45.5 years; female: 50%). Utility for epcoritamab monotherapy was 0.459 for Cycle 1, 0.585 for Cycle 2-3, 0.642 for Cycle 4-9 and 0.678 for Cycle 10+ and beyond. Utilities for R-ICE were 0.151 for Cycle 1 and 0.380 for Cycle 2+; for Pola-BR were 0.216 for Cycle 1 and 0.490 for Cycle 2+. Relative to Pola-BR and R-ICE, epcoritamab was associated with higher utility values at all corresponding cycles, with differences of 0.243 and 0.307 in Cycle 1 and 0.094 and 0.205 in Cycles 2-3, respectively.

This study provides early economic insights, based on general population preferences, suggesting that epcoritamab's subcutaneous injection and outpatient administration beyond Cycle 2 may be associated with improved QOL compared to other therapies, regardless of efficacy and safety.