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在中国复发或难治性弥漫性大B细胞淋巴瘤患者中,戈利妥单抗与利妥昔单抗的成本效益分析。

Cost-effectiveness analysis of glofitamab versus rituximab for relapsed or refractory diffuse large B-cell lymphoma patients in China.

作者信息

Zheng Hanrui, Zou Linke, Hu Ming

机构信息

Department of Clinical Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, China.

出版信息

Int J Clin Pharm. 2025 Apr 28. doi: 10.1007/s11096-025-01912-4.

Abstract

BACKGROUND

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).

AIM

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.

METHOD

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.

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.

CONCLUSION

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.

摘要

背景

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。

目的

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。

方法

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。

结果

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。

结论

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。

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