Analisi di costo-efficacia di Brentuximab Vedotin + CHP in pazienti con linfoma anaplastico a grandi cellule sistemico [Cost-effectiveness of Brentuximab Vedotin plus chemotherapy as frontline treatment of systemic anaplastic large cell lymphoma in Italy

Objective:Systemic anaplastic large cell lymphoma (sALCL) is a rare and severe non-Hodgkin lymphoma. Despite its clinical relevance, the aetiology of this disease is unknown, not allowing the patient to prevent and counteract it. This study investigates the cost-effectiveness of Brentuximab Vedotin (BV) in combination with cyclophospha-mide, doxorubicin and prednisone (CHP) for the front-line treatment of patients with sALCL in Italy.Methods: The analysis was conducted from the perspective of the National Health Service using a three-state partitioned survival model with cycles lasting 21 days and a lifetime time horizon. The survival curves were taken from three-year follow-up data of ECHELON-2 trial. Costs were obtained from published literature and national tariffs. For all drugs, ex-factory prices net of the mandatory reductions required by law were considered.Results: Compared with CHOP, BV in combination with CHP was associated with an increase of € 46,349 total costs, 2.3 life years and 1.8 quality-adjusted life-years (QALYs) respectively. The incremental cost-utility ratios (ICUR) were estimated equal to € 25,367/QALY compared with CHOP, resulting below the value of € 41,411/QALY for severe diseases in Italy.Conclusions: Based on data from 3 years of follow-up from the ECHELON-2 trial, BV in combination with CHP is estimated a cost-effective option versus CHOP for the front-line treatment of sALCL in Italy. Data from 5-year from the ECHELON-2 trial confirmed the advantage in terms of PFS and OS. The analysis also suggested that treatment with BV+CHP may be cost-effective compared with CHOEP.