PCN90 ASSESSMENT OF UTILITIES FOR ADVERSE EVENTS (AES) ASSOCIATED WITH CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL THERAPY IN LARGE B-CELL LYMPHOMA (LBCL)

Abstract

CAR T-cell therapy is a promising treatment for LBCL. Cost-utility analyses are needed to examine and compare the value of these therapies, and these models require health state utilities representing the key AEs associated with therapy, including cytokine release syndrome (CRS) and neurological events (NEs). This study estimated utilities for various severity levels of CRS and NEs associated with CAR T-cell therapy. We used time trade-off methodology—a widely used methodology for assessing preference-based health-related quality of life—to conduct interviews with general population participants in the United Kingdom (London and Edinburgh). Participants valued 6 health state vignettes that were drafted based on literature review and clinician input. The first health state represented LBCL treated with CAR T-cell therapy without AEs. The other 5 health states described CRS or NEs of varying severity following CAR T-cell therapy. The disutilities (i.e., utility decrease) associated with these AEs were calculated by subtracting the utility of the health state without AEs from those of the other health states. Interviews were conducted with 218 participants (London, n=113; Edinburgh, n=105; 50% male; mean age, 49 years). The mean (standard deviation [SD]) utility for CAR T-cell therapy without AEs was 0.73 (0.30). Mean (SD) disutilities associated with CRS were −0.01 (0.04) for grade 1, −0.05 (0.09) for grade 2, and −0.23 (0.24) for grade 3/4. Mean (SD) disutilities associated with NEs were −0.04 (0.07) for grade 1/2 and −0.18 (0.22) for grade 3/4. More severe AEs were associated with greater disutilities. Because the AEs were added to health states valued with a 1-year time horizon, these disutilities can be applied as quality-adjusted life-year decrements in cost-utility analyses. The health state utilities estimated in this study would be useful in cost-effectiveness models of CAR T-cell therapy in patients with LBCL.