Is first-line treatment with polatuzumab vedotin–rituximab–cyclophosphamide, doxorubicin and prednisone (pola-R-CHP) for previously untreated diffuse large B-cell lymphoma cost-effective in China? A cost-effectiveness analysis using a Markov model
Objective To evaluate the cost-effectiveness of polatuzumab vedotin–rituximab–cyclophosphamide, doxorubicin and prednisone (pola-R-CHP) in CD20-positive patients with previously untreated diffuse large B-cell lymphoma (DLBCL) in China.Design A Markov model was constructed to analyse the cost-effecti...
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BMJ Publishing Group
2025-01-01
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| author | Lin Yang Ting Chen Qiuling Zhao Liangliang Dong Wanfu Zhong Wenbin Liu Xiuliang Qiu Ruyi Huang Shengqiang Huang Ruixiang Xie |
| author_facet | Lin Yang Ting Chen Qiuling Zhao Liangliang Dong Wanfu Zhong Wenbin Liu Xiuliang Qiu Ruyi Huang Shengqiang Huang Ruixiang Xie |
| author_sort | Lin Yang |
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| description | Objective To evaluate the cost-effectiveness of polatuzumab vedotin–rituximab–cyclophosphamide, doxorubicin and prednisone (pola-R-CHP) in CD20-positive patients with previously untreated diffuse large B-cell lymphoma (DLBCL) in China.Design A Markov model was constructed to analyse the cost-effectiveness of two strategies in CD20-positive patients with previously untreated DLBCL over a lifetime horizon: (1) pola-R-CHP and (2) rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). The clinical outcomes were obtained from the POLARIX(NCT03274492), SCHOLAR-1, ZUMA-7(NCT03391466) and TRANSFORM(NCT03575351) trials. Costs were derived from the Chinese official websites and published literature, and utility values were obtained from the published literature. The willingness-to-pay (WTP) threshold was set at triple the 2023 Chinese per capita gross domestic product of US$38 042.49/quality-adjusted life year (QALY). Uncertainty was addressed using sensitivity analyses. The scenario analyses were also conducted.Setting Chinese healthcare system perspective.Participants A hypothetical cohort of adult patients presenting with CD20-positive, patients with previously untreated DLBCL.Interventions Pola-R-CHP versus R-CHOP.Main outcome measures The main outcomes of the study were QALYs, incremental cost-effectiveness ratio (ICER) and incremental net-health benefit (INHB).Results In China, the ICER and INHB of pola-R-CHP compared with R-CHOP were US$77 036.33/QALY and −1.11 QALYs, respectively. The ICER was above the WTP threshold. Outcomes were most responsive to the price of pola. Probabilistic sensitivity analyses indicated that pola-R-CHP had a low probability of being cost-effective under the current WTP threshold. The scenario analyses demonstrated that when the price of pola fell by more than 32.5% to less than US$33.19/mg, the economic probability of pola-R-CHP was greater than 50% in previously untreated CD20-positive patients with DLBCL in China.Conclusions Pola-R-CHP is not cost-effective in the first-line treatment for previously untreated CD20-positive DLBCL in China. A value-based price for the cost of pola is less than US$33.19/mg. |
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| institution | Kabale University |
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| publishDate | 2025-01-01 |
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| spelling | doaj-art-922bce19f92c4fd6aaaf3e91685df15a2025-01-21T05:40:10ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-086251Is first-line treatment with polatuzumab vedotin–rituximab–cyclophosphamide, doxorubicin and prednisone (pola-R-CHP) for previously untreated diffuse large B-cell lymphoma cost-effective in China? A cost-effectiveness analysis using a Markov modelLin Yang0Ting Chen1Qiuling Zhao2Liangliang Dong3Wanfu Zhong4Wenbin Liu5Xiuliang Qiu6Ruyi Huang7Shengqiang Huang8Ruixiang Xie9Department of Pharmacy, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, People`s Republic of ChinaDepartment of Pharmacy, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, People`s Republic of ChinaDepartment of Pharmacy, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, People`s Republic of ChinaDepartment of Pharmacy, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, People`s Republic of ChinaDepartment of Pharmacy, Xianyou County General Hospital, Putian, People`s Republic of ChinaDepartment of Pharmacy, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, People`s Republic of ChinaDepartment of Pharmacy, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, People`s Republic of ChinaDepartment of Pharmacy, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, People`s Republic of ChinaDepartment of Pharmacy, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, People`s Republic of ChinaDepartment of Pharmacy, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, People`s Republic of ChinaObjective To evaluate the cost-effectiveness of polatuzumab vedotin–rituximab–cyclophosphamide, doxorubicin and prednisone (pola-R-CHP) in CD20-positive patients with previously untreated diffuse large B-cell lymphoma (DLBCL) in China.Design A Markov model was constructed to analyse the cost-effectiveness of two strategies in CD20-positive patients with previously untreated DLBCL over a lifetime horizon: (1) pola-R-CHP and (2) rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). The clinical outcomes were obtained from the POLARIX(NCT03274492), SCHOLAR-1, ZUMA-7(NCT03391466) and TRANSFORM(NCT03575351) trials. Costs were derived from the Chinese official websites and published literature, and utility values were obtained from the published literature. The willingness-to-pay (WTP) threshold was set at triple the 2023 Chinese per capita gross domestic product of US$38 042.49/quality-adjusted life year (QALY). Uncertainty was addressed using sensitivity analyses. The scenario analyses were also conducted.Setting Chinese healthcare system perspective.Participants A hypothetical cohort of adult patients presenting with CD20-positive, patients with previously untreated DLBCL.Interventions Pola-R-CHP versus R-CHOP.Main outcome measures The main outcomes of the study were QALYs, incremental cost-effectiveness ratio (ICER) and incremental net-health benefit (INHB).Results In China, the ICER and INHB of pola-R-CHP compared with R-CHOP were US$77 036.33/QALY and −1.11 QALYs, respectively. The ICER was above the WTP threshold. Outcomes were most responsive to the price of pola. Probabilistic sensitivity analyses indicated that pola-R-CHP had a low probability of being cost-effective under the current WTP threshold. The scenario analyses demonstrated that when the price of pola fell by more than 32.5% to less than US$33.19/mg, the economic probability of pola-R-CHP was greater than 50% in previously untreated CD20-positive patients with DLBCL in China.Conclusions Pola-R-CHP is not cost-effective in the first-line treatment for previously untreated CD20-positive DLBCL in China. A value-based price for the cost of pola is less than US$33.19/mg.https://bmjopen.bmj.com/content/15/1/e086251.full |
| spellingShingle | Lin Yang Ting Chen Qiuling Zhao Liangliang Dong Wanfu Zhong Wenbin Liu Xiuliang Qiu Ruyi Huang Shengqiang Huang Ruixiang Xie Is first-line treatment with polatuzumab vedotin–rituximab–cyclophosphamide, doxorubicin and prednisone (pola-R-CHP) for previously untreated diffuse large B-cell lymphoma cost-effective in China? A cost-effectiveness analysis using a Markov model BMJ Open |
| title | Is first-line treatment with polatuzumab vedotin–rituximab–cyclophosphamide, doxorubicin and prednisone (pola-R-CHP) for previously untreated diffuse large B-cell lymphoma cost-effective in China? A cost-effectiveness analysis using a Markov model |
| title_full | Is first-line treatment with polatuzumab vedotin–rituximab–cyclophosphamide, doxorubicin and prednisone (pola-R-CHP) for previously untreated diffuse large B-cell lymphoma cost-effective in China? A cost-effectiveness analysis using a Markov model |
| title_fullStr | Is first-line treatment with polatuzumab vedotin–rituximab–cyclophosphamide, doxorubicin and prednisone (pola-R-CHP) for previously untreated diffuse large B-cell lymphoma cost-effective in China? A cost-effectiveness analysis using a Markov model |
| title_full_unstemmed | Is first-line treatment with polatuzumab vedotin–rituximab–cyclophosphamide, doxorubicin and prednisone (pola-R-CHP) for previously untreated diffuse large B-cell lymphoma cost-effective in China? A cost-effectiveness analysis using a Markov model |
| title_short | Is first-line treatment with polatuzumab vedotin–rituximab–cyclophosphamide, doxorubicin and prednisone (pola-R-CHP) for previously untreated diffuse large B-cell lymphoma cost-effective in China? A cost-effectiveness analysis using a Markov model |
| title_sort | is first line treatment with polatuzumab vedotin rituximab cyclophosphamide doxorubicin and prednisone pola r chp for previously untreated diffuse large b cell lymphoma cost effective in china a cost effectiveness analysis using a markov model |
| url | https://bmjopen.bmj.com/content/15/1/e086251.full |
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