Table 3.
Cost-effectiveness base case results
| Axi-cel versus liso-cel | Axi-cel versus tisa-cel | |||||
|---|---|---|---|---|---|---|
| Axi-cel matched to liso-cel | Liso-cel | Δ | Axi-cel matched to tisa-cel | Tisa-cel | Δ | |
| A | B | A− B | C | D | C− D | |
| Total direct medical costs | $637,129 | $620,962 | $16,167 | $631,331 | $576,563 | $54,769 |
| Pre/day of infusion | $402,280 | $414,959 | − $12,679 | $402,280 | $379,798 | $22,481 |
| CAR T cell acquisition | $399,000 | $410,300 | − $11,300 | $399,000 | $373,000 | $26,000 |
| Apheresis | $112 | $112 | $0 | $112 | $112 | $0 |
| Bridging therapy | $0 | $2025 | − $2025 | $0 | $3,148 | − $3148 |
| Conditioning chemotherapy | $3020 | $2374 | $646 | $3020 | $3391 | − $371 |
| CAR T cell administration | $148 | $148 | $0 | $148 | $148 | $0 |
| Post infusion (excluding end of life care) | $192,408 | $159,583 | $32,824 | $229,052 | $196,764 | $32,287 |
| Near term (t ≤ 90 days) | $58,837 | $57,759 | $1078 | $58,843 | $57,239 | $1604 |
| Inpatient ICU | $12,988 | $12,397 | $590 | $12,954 | $12,416 | $538 |
| Inpatient non-ICU | $44,947 | $44,477 | $470 | $44,985 | $43,970 | $1015 |
| ED | $7 | $5 | $2 | $7 | $6 | $1 |
| Outpatient | $896 | $880 | $16 | $897 | $847 | $50 |
| Long term (t > 90 days) | $94,698 | $71,258 | $23,440 | $88,371 | $65,924 | $22,447 |
| Pre progression | $84,080 | $65,025 | $19,056 | $75,971 | $50,870 | $25,101 |
| Post progression | $10,618 | $6234 | $4384 | $12,400 | $15,054 | − $2654 |
| Other | $38,872 | $30,566 | $8307 | $38,474 | $25,689 | $12,785 |
| SCT | $23,842 | $21,683 | $2159 | $23,789 | $14,696 | $9093 |
| IVIG | $15,030 | $8883 | $6148 | $14,685 | $10,993 | $3692 |
| End of life care | $42,442 | $46,420 | – $3978 | $43,364 | $47,913 | − $4549 |
| Total life years | 9.787 | 7.460 | 2.326 | 9.251 | 6.568 | 2.683 |
| Pre progression | 9.294 | 7.148 | 2.145 | 8.671 | 5.834 | 2.837 |
| Post progression | 0.493 | 0.312 | 0.181 | 0.580 | 0.734 | − 0.154 |
| Total quality-adjusted life-years | 7.705 | 5.898 | 1.807 | 7.240 | 5.005 | 2.235 |
| On CAR T cell therapy (t ≤ 30 days) | 0.061 | 0.060 | < 0.001 | 0.061 | 0.060 | < 0.001 |
| Off therapy, t > 30 days | 7.644 | 5.838 | 1.807 | 7.180 | 4.945 | 2.235 |
| Pre progression | 7.452 | 5.717 | 1.736 | 6.954 | 4.661 | 2.293 |
| Post progression | 0.192 | 0.121 | 0.071 | 0.226 | 0.284 | − 0.058 |
| Net monetary benefit | $518,624 | $263,711 | $254,913 | $454,719 | $174,246 | $280,472 |
| ICER (axi-cel versus comparator) | – | – | $8946 | – | – | $24,506 |
CAR chimeric antigen receptor, ED Emergency Department, ICER incremental cost-effectiveness ratio, ICU Intensive Care Unit, IVIG intravenous immune globulin, SCT stem cell transplant