Cost-effectiveness analysis alongside the inter-B-NHL ritux 2010 trial: rituximab in children and adolescents with B cell non-Hodgkin’s lymphoma

Béranger Lueza, Anne Aupérin, Charlotte Rigaud, T.G. Gross, Marta Pillon, R.F. Delgado, A. Uyttebroeck, Gladstone Austin Amos Burke, Jõzsef Zsíros, M. Csóka, Mathieu Simonin, C. Patte, V. Minard-Colin and Julia Bonastre ()
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Béranger Lueza: IGR - Institut Gustave Roussy, SBE - Service de biostatistique et d'épidémiologie - Direction de la recherche clinique [Gustave Roussy] - IGR - Institut Gustave Roussy
Anne Aupérin: CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay, IGR - Institut Gustave Roussy, SBE - Service de biostatistique et d'épidémiologie - Direction de la recherche clinique [Gustave Roussy] - IGR - Institut Gustave Roussy
Charlotte Rigaud: Département de cancérologie de l'enfant et de l'adolescent [Gustave Roussy] - IGR - Institut Gustave Roussy
T.G. Gross: Children’s Hospital Colorado - University of Colorado Anschutz Medical Campus [Aurora]
Marta Pillon: Unipd - Università degli Studi di Padova = University of Padua
R.F. Delgado: UV - Universitat de València = University of Valencia
A. Uyttebroeck: University Hospitals Leuven [Leuven]
Gladstone Austin Amos Burke: Addenbrooke's Hospital - Cambridge University NHS Trust
Jõzsef Zsíros: Princess Máxima Center for Pediatric Oncology [Utrecht, Netherlands]
M. Csóka: Semmelweis University [Budapest]
Mathieu Simonin: CHU Trousseau [APHP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - SU - Sorbonne Université, SU - Sorbonne Université
C. Patte: Département de cancérologie de l'enfant et de l'adolescent [Gustave Roussy] - IGR - Institut Gustave Roussy
V. Minard-Colin: Département de cancérologie de l'enfant et de l'adolescent [Gustave Roussy] - IGR - Institut Gustave Roussy, IGR - Institut Gustave Roussy, ITIC - Immunologie anti-tumorale et immunothérapie des cancers - IGR - Institut Gustave Roussy - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay
Julia Bonastre: CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay, IGR - Institut Gustave Roussy, SBE - Service de biostatistique et d'épidémiologie - Direction de la recherche clinique [Gustave Roussy] - IGR - Institut Gustave Roussy

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Abstract: Objectives: The randomized controlled trial Inter-B-NHL ritux 2010 showed overall survival (OS) benefit and event-free survival (EFS) benefit with the addition of rituximab to standard Lymphomes Malins B (LMB) chemotherapy in children and adolescents with high-risk, mature B cell non-Hodgkin's lymphoma. Our aim was to assess the cost-effectiveness of rituximab-chemotherapy versus chemotherapy alone in the French setting. Methods: We used a decision-analytic semi-Markov model with four health states and 1-month cycles. Resource use was prospectively collected in the Inter-B-NHL ritux 2010 trial (NCT01516580). Transition probabilities were assessed from patient-level data from the trial (n = 328). In the base case analysis, direct medical costs from the French National Insurance Scheme and life-years (LYs) were computed in both arms over a 3-year time horizon. Incremental net monetary benefit and cost-effectiveness acceptability curve were computed through a probabilistic sensitivity analysis. Deterministic sensitivity analysis and several sensitivity analyses on key assumptions were also conducted, including one exploratory analysis with quality-adjusted life years as the health outcome. Results: OS and EFS benefits shown in the Inter-B-NHL ritux 2010 trial translated into the model by rituximab-chemotherapy being the most effective and also the least expensive strategy over the chemotherapy strategy. The mean difference in LYs between arms was 0.13 [95% CI 0.02; 0.25], and the mean cost difference € − 3 710 [95% CI € − 17,877; € 10,525] in favor of rituximab-chemotherapy group. For a € 50,000 per LY willingness-to-pay threshold, the probability of the rituximab-chemotherapy strategy being cost-effective was 91.1%. All sensitivity analyses confirmed these findings. Conclusion: Adding rituximab to LMB chemotherapy in children and adolescents with high-risk mature B-cell non-Hodgkin's lymphoma is highly cost-effective in France. Trial registration: ClinicalTrials.gov identifier: NCT01516580.

Keywords: Economic evaluation; High-risk B-NHL; Immunotherapy; Semi-Markov model (search for similar items in EconPapers)
Date: 2023
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Published in European Journal of Health Economics, 2023, ⟨10.1007/s10198-023-01581-y⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-04122856

DOI: 10.1007/s10198-023-01581-y

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