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Cost-effectiveness analysis alongside the inter-B-NHL ritux 2010 trial: rituximab in children and adolescents with B cell non-Hodgkin’s lymphoma

Author

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  • Béranger Lueza

    (Gustave Roussy, Université Paris-Saclay
    INSERM 1018, Université Paris-Saclay, UVSQ)

  • Anne Aupérin

    (Gustave Roussy, Université Paris-Saclay
    INSERM 1018, Université Paris-Saclay, UVSQ)

  • Charlotte Rigaud

    (Gustave Roussy, Université Paris-Saclay)

  • Thomas G. Gross

    (Children’s Hospital Colorado)

  • Marta Pillon

    (University of Padova)

  • Rafael F. Delgado

    (University of Valencia)

  • Anne Uyttebroeck

    (University Hospitals Leuven)

  • G. A. Amos Burke

    (Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital)

  • József Zsíros

    (Princess Máxima Center for Pediatric Oncology)

  • Monika Csóka

    (Semmelweis University)

  • Mathieu Simonin

    (Armand Trousseau Hospital-APHP, Sorbonne University)

  • Catherine Patte

    (Gustave Roussy, Université Paris-Saclay)

  • Véronique Minard-Colin

    (Gustave Roussy, Université Paris-Saclay
    INSERM 1015, Gustave Roussy, Université Paris-Saclay)

  • Julia Bonastre

    (Gustave Roussy, Université Paris-Saclay
    INSERM 1018, Université Paris-Saclay, UVSQ)

Abstract

Objectives The randomized controlled trial Inter-B-NHL ritux 2010 showed overall survival (OS) benefit and event-free survival (EFS) benefit with the addition of rituximab to standard Lymphomes Malins B (LMB) chemotherapy in children and adolescents with high-risk, mature B cell non-Hodgkin’s lymphoma. Our aim was to assess the cost-effectiveness of rituximab-chemotherapy versus chemotherapy alone in the French setting. Methods We used a decision-analytic semi-Markov model with four health states and 1-month cycles. Resource use was prospectively collected in the Inter-B-NHL ritux 2010 trial (NCT01516580). Transition probabilities were assessed from patient-level data from the trial (n = 328). In the base case analysis, direct medical costs from the French National Insurance Scheme and life-years (LYs) were computed in both arms over a 3-year time horizon. Incremental net monetary benefit and cost-effectiveness acceptability curve were computed through a probabilistic sensitivity analysis. Deterministic sensitivity analysis and several sensitivity analyses on key assumptions were also conducted, including one exploratory analysis with quality-adjusted life years as the health outcome. Results OS and EFS benefits shown in the Inter-B-NHL ritux 2010 trial translated into the model by rituximab-chemotherapy being the most effective and also the least expensive strategy over the chemotherapy strategy. The mean difference in LYs between arms was 0.13 [95% CI 0.02; 0.25], and the mean cost difference € − 3 710 [95% CI € − 17,877; € 10,525] in favor of rituximab-chemotherapy group. For a € 50,000 per LY willingness-to-pay threshold, the probability of the rituximab-chemotherapy strategy being cost-effective was 91.1%. All sensitivity analyses confirmed these findings. Conclusion Adding rituximab to LMB chemotherapy in children and adolescents with high-risk mature B-cell non-Hodgkin's lymphoma is highly cost-effective in France. Trial registration ClinicalTrials.gov identifier: NCT01516580.

Suggested Citation

  • Béranger Lueza & Anne Aupérin & Charlotte Rigaud & Thomas G. Gross & Marta Pillon & Rafael F. Delgado & Anne Uyttebroeck & G. A. Amos Burke & József Zsíros & Monika Csóka & Mathieu Simonin & Catherine, 2024. "Cost-effectiveness analysis alongside the inter-B-NHL ritux 2010 trial: rituximab in children and adolescents with B cell non-Hodgkin’s lymphoma," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(2), pages 307-317, March.
    • Handle: RePEc:spr:eujhec:v:25:y:2024:i:2:d:10.1007_s10198-023-01581-y
    DOI: 10.1007/s10198-023-01581-y
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