Arzerra “Highly Cost-Effective” Among Patients With Relapsed Chronic Lymphocytic Leukemia

Recent data presented at the 2016 ASH Annual Meeting and Exposition showed that use of Arzerra (ofatumumab; Novartis) in combination with fludarabine and cyclophosphamide was more cost-effective than fludarabine and cyclophosphamide alone. 

“In a phase 3 COMPLEMENT 2 study, [Arzerra] plus fludarabine and cyclophosphamide demonstrated significantly improved median progression-free survival by 54% compared to fludarabine and cyclophosphamide treatment alone in patients with relapsed chronic lymphocytic leukemia.” Vasudha Bal, MSc, MBA, director of global value and access at Novartis Pharmaceuticals said during a presentation. “However, the relative value of [Arzerra] in relapsed chronic lymphocytic leukemia has not been formally assessed. The objective of this study was to estimate the incremental cost per (quality-adjusted) life-year of utilizing [Arzerra] plus fludarabine and cyclophosphamide vs fludarabine and cyclophosphamide for relapsed chronic lymphocytic leukemia in the United States.”

In order to study the cost-effectiveness of Arzerra, the researchers developed and utilized a partial survival model comparing the two therapy options over a patient’s lifetime. They used study data from the COMPLEMENT 2 study in order to estimate rates of progression-free survival, overall survival, and frequencies of adverse events. The model included costs associated with treatment, such as administration for primary therapies, adverse events treatments, hospitalization costs, provide visit costs, and end-of-life costs. 

Study results showed that there was an 85% chance of Arzerra plus fludarabine and cyclophosphamide being cost-effective compared to fludarabine and cyclophosphamide alone when calculated against a societal willingness-to-pay threshold of $100,000 per quality-adjusted life-year saved.

According to the results, Arzerra plus fludarabine and cyclophosphamide added 0.803 life years and 0.543 quality-adjusted life years more than fludarabine and cyclophosphamide alone.

Although the total cost for Arzerra plus fludarabine and cyclophosphamide was higher, at $6693 per-patient, the incremental cost-effectiveness ratio per life year and quality-adjusted life year gained was lower for this combination, at $8333 vs $12,322. —David Costill