title: Cost-effectiveness of rituximab as maintenance therapy in patients with follicular non-Hodgkin lymphoma after responding to first-line rituximab plus chemotherapy.
abstract: A recent phase III trial demonstrated that maintenance rituximab® therapy after response to first-line treatment with rituximab plus chemotherapy (R-chemo) increases progression-free survival (PFS) for follicular non-Hodgkin lymphoma (f-NHL). A cost-effectiveness analysis of R-maintenance versus observation was conducted from a US payer perspective to estimate PFS and overall survival (OS) over a representative patient's lifetime. Primary outcomes were cost per life-year gained (LYG) and cost per quality-adjusted life-year (QALY) gained. Compared with observation, R-maintenance increased mean PFS by 1.50 years, OS by 1.21 years and QALYs gained by 1.11 years. The incremental cost of maintenance therapy was $38,545. The costs per LYG and QALY gained were $31,934 and $34,842, respectively. Within the limitations of modeling long-term outcomes, R-maintenance therapy in patients who received R-chemo for previously untreated f-NHL compared with observation alone after R-chemo for first-line treatment for f-NHL is cost-effective from the US payer perspective.
authors.affiliation: Cedar Associates LLC, Menlo Park, CA, USA. jhornberger@cedarecon.com
authors.forename: John
authors.initials: J
authors.lastname: Hornberger
authors.forename: Rebecca
authors.initials: R
authors.lastname: Chien
authors.forename: Mark
authors.initials: M
authors.lastname: Friedmann
authors.forename: Leona
authors.initials: L
authors.lastname: Han
authors.forename: Ashwini
authors.initials: A
authors.lastname: Shewade
authors.forename: Sacha
authors.initials: S
authors.lastname: Satram-Hoang
authors.forename: Carolina
authors.initials: C
authors.lastname: Reyes
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017326:Clinical Trials, Phase III as Topic / Q000191:economics; D003362:Cost-Benefit Analysis; D018572:Disease-Free Survival; D016527:Drug Costs / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy*; D060046:Maintenance Chemotherapy / Q000191:economics* / Q000379:methods; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic / Q000191:economics; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab