Health care resource use in the management of patients with relapsed/refractory diffuse large B-cell lymphoma – Canadian perspective

Aim: Epcoritamab, the first subcutaneous (SC) bispecific approved for relapsed/refractory diffuse large B-cell lymphoma (R/R-DLBCL), offers potential advantages in terms of healthcare resource utilization (HCRU) associated with its SC administration. This study aimed to estimate HCRU and associated costs of R/R-DLBCL treatments, to inform health technology assessment agencies, institutional decision makers and healthcare professionals (HCP) from both a Canadian and Quebec perspective. Secondary objectives included using a societal perspective and estimating chair time and HCP time involved in administering treatments. Materials & methods: A 1-year costing analysis was developed comparing epcoritamab to other R/R-DLBCL treatments, including glofitamab, CAR-T cell therapies, chemotherapy, Pola-BR and Tafa-Len. HCRU and associated costs included pretreatment, administration, monitoring, and adverse event management. Acquisition costs of active treatments were excluded. Multiple time horizons were assessed. Model inputs were retrieved from product labels and validated by clinical experts to reflect practice. Results: From the Canadian and Quebec healthcare system perspective, total 1-year HCRU costs ranged from $11,009 to $54,946 and $10,041 to $54,362, respectively. Epcoritamab ranked as the second least costly comparator after chemotherapy, with notable HCRU savings driven by low administration costs of SC injections and adverse event management costs. Epcoritamab ranked similarly from a societal perspective and scenario analysis evaluating a 2-year time-horizon. Epcoritamab had the lowest annual chair time and HCP time, freeing up resources and HCP availability. Conclusion: Considering the highly constrained Canadian healthcare system, SC epcoritamab offers substantial HCRU-related cost saving, chair time savings and HCP time savings when compared with other available treatments, making it an effective, efficient and patient-centric treatment option for R/R-DLBCL in Canada.