Fixed-Duration Mosunetuzumab Offers Effective and Budget-Friendly Option for Relapsed Follicular Lymphoma
Mosunetuzumab adds a highly effective, fixed-duration treatment option for patients with relapsed or refractory (R/R) follicular lymphoma (FL), with minimal financial impact to payers.
Despite multiple approved treatments for R/R FL, including phosphoinositide 3-kinase inhibitors (PI3K) inhibitors, enhancer of zeste homolog 2 (EZH2) inhibitors, and chimeric antigen receptor (CAR) T-cell therapies, many options are either no longer US Food and Drug Administration (FDA)-approved or require continuous dosing. CAR T-cell therapies, though effective, are resource-intensive and associated with high-grade cytokine release syndrome (CRS). In contrast, mosunetuzumab, a CD20xCD3 T-cell–engaging bispecific antibody, is administered in a fixed-duration schedule and has demonstrated promising results in the phase II GO29781 trial, with an 80% overall response rate and 60% complete response rate.
“To address the budgetary concerns from payers over the inclusion of mosunetuzumab to their formularies, we developed a budget impact model (BIM) to analyze the per patient cost and budget impact of introducing mosunetuzumab as treatment for R/R FL from a third-party payer perspective,” authors explained.
To estimate the budgetary effect of adopting mosunetuzumab, researchers modeled 2 treatment landscapes (1 excluding and 1 including mosunetuzumab) within a hypothetical 1-million-member health plan. The model incorporated drug acquisition, administration, adverse event management, CRS costs, and routine care. Over 3 years, the budget impact of adding mosunetuzumab was only $69 812 total, corresponding to a 1% increase. Notably, its per patient cumulative cost was lower than most other new therapies.
Mosunetuzumab had the lowest CRS-related cost among newer therapies and 0 drug wastage. Its administration cost ($1878) was significantly less than those for CAR T-cell therapies, which ranged from $27 121 to $32 045. Sensitivity analyses confirmed that even with changes to pricing, uptake, or duration assumptions, mosunetuzumab remained a low-cost option.
“Providing access to mosunetuzumab, a fixed-duration therapy with a newer mechanism of action for the treatment of adult patients with R/R FL, provides a new treatment option to patients, which at the same time should have a minimal budget impact on US health plans over a 3-year time horizon,” concluded the study authors.
Reference
Lin SW, Shapouri S, Parisé H, et al. Budget impact of introducing fixed-duration mosunetuzumab for the treatment of relapsed or refractory follicular lymphoma after two or more lines of systemic therapy in the USA. Pharmacoeconomics. 2024;42(5):569-582. doi:10.1007/s40273-024-01358-y
