International Cost‐Effectiveness Analysis of Nivolumab Versus Brentuximab Vedotin for Patients With Advanced‐Stage Classic Hodgkin's Lymphoma

Programmed death-1 (PD-1) blockade offers a survival advantage over antibody-drug conjugate (ADC) treatment in classic Hodgkin lymphoma (cHL). As such, an updated pharmacoeconomic analysis of these different therapeutic strategies is indicated. This study therefore assessed the cost-effectiveness of nivolumab combined with doxorubicin, vinblastine, and dacarbazine (N-AVD) to that of brentuximab vedotin with AVD (BV-AVD). A three-state Markov model was developed to assess lifetime costs and efficacy for N-AVD and BV-ACVD regimens as treatments for adolescent and adult cHL patients from the perspectives of payers in China and the USA, using respective willingness to pay (WTP) thresholds of $37,608 and $150,000 per quality-adjusted life year (QALY). Primary analytical outcomes included direct medical costs, lifetime efficacy, incremental cost-effectiveness ratio (ICERs), and incremental net health benefit (INHB). Model stability was tested through sensitivity and subgroup analyses. N-AVD treatment yielded 1.41-2.01 and 1.06-1.39 QALYs over BV-AVD for cHL patients in the USA and China, respectively. Incremental healthcare costs for first-line N-AVD treatment were -$746,249 to $393,009 and -$109,358 to $292,324 compared to BV-AVD treatment, for corresponding ICERs of -$432,098/QALY to $288,541/QALY and -$79,173/QALY to $275,376/QALY in the USA and China, respectively. Sensitivity analyses suggested that the utility of progression-free survival had an influence on the results of these cost-effectiveness analyses. N-AVD and BV-AVD are cost-effective approaches to treating patients with cHL in both the USA and China. N-AVD and BV-AVD may respectively be best suited to use as treatments for adolescents and elderly individuals.