Work

Cost-effectiveness analysis of ibrutinib plus venetoclax for relapsed or refractory mantle cell lymphoma in China and the United States

Year: 2026

Type: article

Abstract: Background: The SYMPATICO trial demonstrated that ibrutinib combined with venetoclax significantly improved progression-free survival in patients with relapsed or refractory (R/R) mantle cell lymphoma (MCL). This study evaluated the cost-effectiveness of the combination of ibrutinib-venetoclax for R/R MCL from the healthcare perspectives of China and the United States (US). Methods: A partitioned survival model with a 35-year simulation time horizon was developed to compare the cost-effectiveness of ibrutinib-venetoclax versus ibrutinib-placebo. Primary outcomes included total costs, life-years (LYs), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). The robustness of the model was evaluated through one-way sensitivity analysis (OWSA) and probabilistic sensitivity analysis (PSA). Results: Base-case analysis showed that the ICER of ibrutinib-venetoclax versus ibrutinib-placebo was $128,183.93/QALY in China, which was significantly higher than the willingness-to-pay (WTP) threshold of $40,334/QALY. It was still not cost-effective below the $150,000/QALY WTP threshold in the US, with an ICER of $951,082.87/QALY. OWSA demonstrated the robustness of the model. PSA showed that ibrutinib-venetoclax had a 0% probability of being cost-effective under the current WTP thresholds in China and the US. Price reduction analysis indicated that in China, reducing the price of venetoclax to 20% of its original cost could achieve cost-effectiveness with a 60.80% probability. In the US, a combined price reduction of ibrutinib and venetoclax to 22.53% of their original costs is necessary to achieve a 50% probability of cost-effectiveness. Conclusion: Ibrutinib-venetoclax is unlikely to be cost-effective versus ibrutinib-placebo for R/R MCL in both China and the US.

Source: Frontiers in Public Health

DOI: 10.3389/fpubh.2026.1817037

Authors: Jing He, Xianxi Liu, Qing Yang

Institutions: University of Electronic Science and Technology of China, Chengdu Medical College, Sichuan Cancer Hospital

Language: English

Topic: Health Systems, Economic Evaluations, Quality of Life

Subfield: Economics and Econometrics

Field: Economics, Econometrics and Finance

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801