Abstract
BackgroundPatients with relapsed or refractory peripheral T-cell lymphoma (R/R PTCL) treated with pralatrexate have previously shown superior overall survival (OS) compared to those who underwent conventional chemotherapy (CC, 15.4 vs. 4.07 months). We conducted an economic evaluation of pralatrexate from a societal perspective in Korea based on data from the PROPEL phase II study.MethodsUsing a Markov model with a weekly cycle, we simulated the experience of patients with R/R PTCL receiving pralatrexate or CC for 15 years. The model consists of five health states; initial treatment, treatment pause, subsequent treatment, stem cell transplantation (SCT) success, and death. Comparative effectiveness was based on PROPEL phase II single-arm study and its matched historical control analysis. Costs included drug, drug administration, monitoring, adverse event management, and SCT costs.ResultsThe incremental cost-effectiveness ratio of the base case was $39,153 per quality-adjusted life-year (QALY) gained. The results of one-way sensitivity analysis ranged from $33,949 to $51,846 per QALY gained, which remained within an implicit willingness-to-pay (WTP) threshold of anticancer drugs in Korea.ConclusionsPralatrexate is a cost-effective intervention with improved OS and incremental costs within the WTP limit. Pralatrexate could function as a new therapeutic option for patients suffering from life-threatening R/R PTCL.
Highlights
Patients with relapsed or refractory peripheral T-cell lymphoma (R/R Peripheral T-cell lymphoma (PTCL)) treated with pralatrexate have previously shown superior overall survival (OS) compared to those who underwent conventional chemotherapy (CC, 15.4 vs. 4.07 months)
Except “stem cell transplantation (SCT) success” and “death” states, each health state was composed of four nested states; complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD)
Among the Korean patients included in the case-matched control analysis (CMCA) study [7], 19.8, 21.4, 3.2%, or 55.6% achieve CR, PR, SD, or PD following initial treatment with CC, respectively
Summary
Patients with relapsed or refractory peripheral T-cell lymphoma (R/R PTCL) treated with pralatrexate have previously shown superior overall survival (OS) compared to those who underwent conventional chemotherapy (CC, 15.4 vs. 4.07 months). Peripheral T-cell lymphoma (PTCL) is an aggressive and heterogeneous type of lymphoma that constitutes 7% of non-Hodgkin lymphoma (NHL) [1]. In contrast to other NHLs, PTCL has poor treatment outcomes with a five-year survival rate of 32% [4]. 68% of patients with PTCL are relapsed or refractory (R/R) to conventional chemotherapy (CC) [5]. Prognosis is more unfavorable for R/R PTCL, and no standard care exists. Median overall survival (OS) is 5.8 months, with three-year OS rates of less than 30% [5]
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