Brentuximab vedotin in adult patients with HL CD30+ at high risk of relapse or progression following ASCT: a cost-analysis in Italy

Abstract

Abstract Introduction: In Hodgkin Lymphoma (HL), the early administration of brentuximab vedotin (BV) represents a highly effective treatment to consolidate patients after autologous stem cell transplantation (ASCT). For this indication, the Summary of Product Characteristics (SPC) reports a lower medical resource utilization in BV vs. placebo. This study aimed at assessing costs accrued by using BV in consolidation after ASCT and compare them with the resource consumption associated with the main options today used in Italy for HL. Methods and results: A cost-analysis based on patients at high risk of relapse (HL CD30+-HR) after ASCT was developed by collecting data about health care consumption (drugs and monitoring). The model is described by two arms, "A," where BV is used as consolidation therapy after ASCT, and "B", where patients are treated only at the time of relapse. A 3-year time horizon and the Italian National Health System perspective were adopted. All data inputs for the analysis were sourced from the available literature and official list prices. The simulation was integrated by sensitivity analysis. The introduction of BV as consolidation therapy would allow savings in terms of drug acquisition and resource consumption. Over a 3-year time frame, the Consolidation arm’s overall expenditure was 137,059€ vs. 225,418€ in the Non-consolidation arm. Early after the ASCT, BV administration guarantees a long period free from relapses (5-year PFS is not reached), thus reducing the clinical and economic burden of the subsequent therapies needed to treat further relapses. Conclusions: The present pharmacoeconomic analysis shows that the introduction of BV as consolidation therapy after ASCT represents a sustainable expenditure for the National Healthcare System (NHS) and a cost-saving paradigm when compared with the drug mainly used for treating the relapses.