Researchers identify significant gaps in knowledge regarding cost-effectiveness, costs and resource use, and health-related quality of life (HRQoL) in follicular (FL) and marginal zone lymphomas (MZL), in a recent review of evidence published in PharmacoEconomics - Open (2020. doi:10.1007/s41669-020-00204-z).
A small body of evidence for HRQOL and cost-effective therapies for FL were noted, but no evidence was reported for MZL.
Three systematic reviews were conducted to identify studies addressing treatment cost-effectiveness and HRQoL in Fl and MZL between 2007 and March 2017. However, just 25 studies met eligibility criteria, and MZL was addressed in only one (which included both follicular and marginal zone lymphoma).
“It is clear there is a marked dearth of evidence, which makes assessing the cost effectiveness of therapies, or even exploring modelling methodology, difficult,” Monga and colleagues wrote.
“Additionally, the lack of utility data, particularly in marginal zone lymphoma, highlights the need for further research to draw comparisons and guide treatment decision making” they added.
Despite a lack of published studies, researchers noted their investigation at least offers the start of an evidence base.
According to their findings, follicular lymphoma studies from the United States identified an incremental cost-effectiveness ratio (ICER) of $28,565 per quality-adjusted life-year for first-line rituximab–cyclophosphamide, vincristine, and prednisone compared with cyclophosphamide, vincristine, and prednisone. For second-line obinutuzumab plus bendamustine followed by obinutuzumab maintenance compared with bendamustine, the ICER was $43,000 per quality-adjusted life-year.
Average lifetime costs for first-line patients in the US ranged from $108,000 for rituximab monotherapy to $130,300 for rituximab–cyclophosphamide, doxorubicin hydrochloride, vincristine and prednisolone.
“Disease progression may be a driver of healthcare resource use, cost, and patient health-related quality of life, however further research is required to confirm this,” researchers added. “Despite treatments being available for patients for follicular lymphoma and marginal zone lymphoma, there remains an unmet need to slow disease progression, improve quality of life for patients, and improve all patient outcomes.”—Jolynn Tumolo
