The cost-effectiveness of rituximab in non-Hodgkin's lymphoma.
Rituximab was the first available genetically engineered monoclonal antibody that targets CD20 proteins on the surface of B-cells. Rituximab is indicated: as the first-line treatment of diffuse-large B-cell non-Hodgkin's lymphoma (NHL) in combination with cyclophosphamide, vincristine, doxorubicin and prednisone (CHOP); as the first-line treatment of stage III-IV follicular NHL in combination with cyclophosphamide, vincristine and prednisolone (CVP); for the treatment of patients with stage III-IV follicular lymphoma who are chemoresistant or in their second or subsequent relapse after chemotherapy; and as maintenance therapy for patients with relapsed/refractory follicular lymphoma responding to induction therapy with chemotherapy with or without rituximab. This article reviews the published economic evaluations of rituximab in the treatment of NHL. The conclusion of these analyses is that rituximab, used both as monotherapy and in combination with chemotherapy, is a cost-effective intervention in the most common forms of NHL, diffuse large B-cell lymphoma and follicular NHL. However, there exists a paucity of published studies on both the clinical and economic analysis of rituximab in the less common NHLs. Currently, rituximab is being evaluated in clinical trials within other NHLs. If it has the same clinical success in these trials as it has had in diffuse large B-cell lymphoma and follicular lymphoma, then it is possible that within a few years rituximab could play a key role in treating patients in all forms of NHL.
RTI-Health Solutions, Williams House, Manchester Science Park, Lloyd Street North, Manchester, M15 6SE, UK. cknight@rti.org.
Christopher
C
Knight
Fiona
F
Maciver