Cost-Effectiveness of Epcoritamab Plus Lenalidomide and Rituximab Versus Lenalidomide and Rituximab for...

The Phase 3 EPCORE FL-1 trial demonstrated that adding epcoritamab to lenalidomide plus rituximab (R²) significantly improved response rates and prolonged progression-free survival in patients with relapsed or refractory (r/r) follicular lymphoma (FL). However, the cost-effectiveness of this combination has not been evaluated. The objective of this study was to assess the cost-effectiveness of epcoritamab plus R² compared with R² alone for patients with r/r FL from a US payer perspective. A three-state Markov model was constructed with a 30-year time horizon to compare costs and health outcomes of epcoritamab plus R² versus R². The primary outcome was the incremental cost-effectiveness ratio (ICER), expressed as cost per quality-adjusted life-year (QALY) gained. Parameter uncertainty was evaluated through one-way sensitivity analysis, probabilistic sensitivity analysis, and scenario analyses. In the base-case analysis, epcoritamab plus R² yielded an additional 3.94 QALYs at an incremental cost of $267,721.01 resulting in an ICER of $67,974.64 per QALY gained compared with R² alone. In the one-way sensitivity analysis, the ICER ranged from $53,819.80 to $82,129.49 per QALY across all parameters tested. In the probabilistic sensitivity analysis, epcoritamab plus R² had a 100% probability of being cost-effective at a willingness-to-pay (WTP) threshold of $150,000 per QALY. From a US payer perspective, epcoritamab plus R² is estimated to be a cost-effective treatment option compared with R² for patients with relapsed or refractory follicular lymphoma at a willingness-to-pay threshold of $150,000 per QALY.