Bristol Myers Squibb, Uxbridge, UK.
Bristol Myers Squibb, Princeton, NJ, USA.
Adv Ther. 2023 May;40(5):2355-2374. doi: 10.1007/s12325-023-02444-x. Epub 2023 Mar 22.
INTRODUCTION: The objective of this study was to evaluate the cost-effectiveness of lisocabtagene maraleucel (liso-cel) versus other available chimeric antigen receptor T-cell therapies, including axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel), in patients who had received at least two prior therapies from a United States (US) commercial third-party payer perspective. METHODS: To capture this heterogeneity in survival outcomes, we used mixture cure models to extrapolate progression-free survival (PFS) and overall survival (OS). Patient-level data from TRANSCEND NHL 001 for liso-cel and reconstructed patient-level data from ZUMA-1 for axi-cel, JULIET for tisa-cel, and SCHOLAR-1 for salvage chemotherapy, derived using the Guyot method, were used for OS and PFS. The model included adverse events associated with liso-cel, axi-cel, and tisa-cel. RESULTS: Liso-cel was less costly (incremental cost of - $74,980) and marginally more effective (0.002 incremental quality-adjusted life-years [QALY]) than axi-cel and had an incremental cost of $67,925 and 2.02 incremental QALYs over tisa-cel in the base case. Results remained consistent in sensitivity analyses, with the liso-cel OS cure fraction being the main driver of cost-effectiveness compared with both axi-cel and tisa-cel. CONCLUSION: This analysis estimated that liso-cel is cost-effective compared with tisa-cel and axi-cel from a commercial US payer perspective.
简介：本研究旨在从美国商业第三方支付者的角度评估 lisocabtagene maraleucel（liso-cel）与其他已上市嵌合抗原受体 T 细胞疗法（包括 axicabtagene ciloleucel [axi-cel] 和 tisagenlecleucel [tisa-cel]）相比在至少接受过两次先前治疗的患者中的成本效益。
方法：为了捕捉生存结果的这种异质性，我们使用混合治愈模型推断无进展生存期（PFS）和总生存期（OS）。从 TRANSCEND NHL 001 中获得 liso-cel 的患者水平数据，从 ZUMA-1 中重建 axi-cel 的患者水平数据，从 JULIET 中获得 tisa-cel 的患者水平数据，从 SCHOLAR-1 中获得挽救性化疗的患者水平数据，使用 Guyot 方法，用于 OS 和 PFS。该模型包括与 liso-cel、axi-cel 和 tisa-cel 相关的不良事件。
结果：liso-cel 的成本更低（增量成本为-74980 美元），效果略高（0.002 个增量质量调整生命年[QALY]），与 axi-cel 相比，liso-cel 的增量成本为 67925 美元，与 tisa-cel 相比，增量 QALY 为 2.02。在敏感性分析中，结果保持一致，与 axi-cel 和 tisa-cel 相比，liso-cel 的 OS 治愈率是成本效益的主要驱动因素。
结论：从商业美国支付者的角度来看，这项分析估计 liso-cel 与 tisa-cel 和 axi-cel 相比具有成本效益。
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