Zheng Hanrui, Zou Linke, Hu Ming
Department of Clinical Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, China.
Int J Clin Pharm. 2025 Apr 28. doi: 10.1007/s11096-025-01912-4.
The CD20 × CD3 bispecific antibody glofitamab combined with gemcitabine and oxaliplatin (Glofit-GemOx) has demonstrated clinical efficacy in treating relapsed or refractory diffuse large B-cell lymphoma (DLBCL).
The aim of this study was to evaluate the cost-effectiveness of Glofit-GemOx versus R-GemOx for relapsed or refractory DLBCL patients following one or more previous lines of therapy from the perspective of healthcare in China.
A three-state partitioned survival model was constructed based on the STARGLO study to assess the cost-effectiveness of Glofit-GemOx versus rituximab-GemOx (R-GemOx). Quality-adjusted life years (QALYs) were used as health outcomes, and the incremental cost-effectiveness ratio (ICER) was calculated. One-way deterministic sensitivity analyses and probabilistic sensitivity analyses were performed on key parameters to assess the robustness of the base analysis results.
The costs in Glofit-GemOx regimen were $266,518.83, whereas the costs of R-GemOx regimen were $43,227.09. Compared with the R-GemOx regimen, the Glofit-GemOx regimen resulted in an increase of 0.85 QALYs, yielding an ICER of $262,696.16 per QALY. The ICER significantly exceeded the willingness-to-pay (WTP) threshold of $38,188/QALY and sensitivity analysis revealed the cost of glofitamab had a substantial effect on results.
Compared with R-GemOx, Glofit-GemOx is not cost-effective compared for relapsed or refractory DLBCL patients in China at current price. A negotiated price reduction for glofitamab could substantially improve its cost-effectiveness profile.
CD20×CD3双特异性抗体戈利木单抗联合吉西他滨和奥沙利铂(Glofit-GemOx)在治疗复发或难治性弥漫性大B细胞淋巴瘤(DLBCL)方面已显示出临床疗效。
本研究旨在从中国医疗保健的角度评估Glofit-GemOx与R-GemOx治疗一线或多线治疗后的复发或难治性DLBCL患者的成本效益。
基于STARGLO研究构建了一个三状态分区生存模型,以评估Glofit-GemOx与利妥昔单抗-吉西他滨-奥沙利铂(R-GemOx)的成本效益。采用质量调整生命年(QALYs)作为健康结果,并计算增量成本效益比(ICER)。对关键参数进行单向确定性敏感性分析和概率敏感性分析,以评估基础分析结果的稳健性。
Glofit-GemOx方案的成本为266,518.83美元,而R-GemOx方案的成本为43,227.09美元。与R-GemOx方案相比,Glofit-GemOx方案使QALYs增加了0.85,ICER为每QALY 262,696.16美元。ICER显著超过了每QALY 38,188美元的支付意愿(WTP)阈值,敏感性分析显示戈利木单抗的成本对结果有重大影响。
与R-GemOx相比,以当前价格,Glofit-GemOx在中国复发或难治性DLBCL患者中不具有成本效益。戈利木单抗的协商降价可显著改善其成本效益状况。