Second-Line Rituximab Maintenance for Follicular Lymphoma Cost-Effective

Caroline Helwick

February 2013, Vol 4, No 2 - ASH Annual Meeting


Atlanta, GA—Dutch investigators found that rituximab (Rituxan) maintenance in the second-line treatment of patients with follicular lymphoma (FL) was cost-effective, as reported at the 2012 American Society of Hematology meeting.

“Outcomes research was conducted to calculate the real-world cost-effectiveness of second-line rituximab maintenance compared to observation in FL patients in the Netherlands,” said Hedwig M. Blommestein, MD, Institute for Medical Technology Assessment, Institute of Health Policy & Management, Erasmus University in Rotterdam, the Netherlands.

Two Dutch population-based registries were used to obtain data on patient characteristics, treatment, and resource utilization of patients diagnosed with FL in the past 20 years. Patients responding to second-line chemotherapy were included in the observation or in the maintenance groups. A Markov model using only daily practice data was applied to calculate real-world cost-effectiveness.

Of 735 patients with FL, 57 patients met the criteria for the observation group and 49 were evaluated for maintenance. The researchers found that the maintenance group received significantly more rituximab in the second line, were evaluable a longer time from diagnosis, had significantly better 3-year overall survival (OS), and had significantly longer time until their next treatment. Three-year OS was 75% for the maintenance group versus 63% for the observation arm (P <.01), Dr Blommestein reported.

Daily practice data resulted in cost-effectiveness ratios of €5512 per quality-adjusted life-year (QALY) in the maintenance arm and €5669 per QALY with observation.

“Real-world FL patients are not identical to trial patients, which emphasizes the importance of studying real-world data,” Dr Blommestein noted. Although findings from nonrandomized groups should be analyzed with caution, he said, adding, “Nevertheless, real-world cost-effectiveness for second-line rituximab maintenance was favorable in our study.”