Mosunetuzumab budget impact analysis in patients with recurrent or refractory follicular lymphoma

Aim. This study aimed to analyze the budget impact of mosunetuzumab use in patients with relapsed or refractory follicular lymphoma in the third and subsequent lines of therapy. Materials and methods. Budget impact analysis, sensitivity analysis. Results. The target population size was 340 people. Analysis of the costs of drug therapy for the third and subsequent lines demonstrated a wide range of costs: the maximum costs are associated with the use of mosunetuzumab (RUB 6,296,060.33, 8 cycles and RUB 11,906,411.12, 17 cycles), and the minimum costs are associated with the use of the GDP regimen without rituximab (RUB 31,390.80). The total costs for 1 year of modeling the current practice for all types of therapy amounted to RUB 891,446,565.79. In current practice, the main share of costs is attributed to the drug duvelisib (47.4 %), followed by the regimen ibrutinib+/-R (25.1 %) and R-B (6.1 %). More than 70 % of the current practice costs are spent on drugs that do not have an official indication for use. The total cost of 1 year of modeling amounted to RUB 693,639,708.26. Over the specified modeling period, the main share of costs was attributed to the following regimens: ibrutinib+/-R (32.3 %) and mosunetuzumab monotherapy (27.2 %). Budget impact analysis demonstrated that the use of mosunetuzumab will save 22.2 % or RUB 197,806,857.54 over 1 year and will allow for additional treatment with mosunetuzumab to 31 new patients. Sensitivity analysis of the budget impact analysis results demonstrated that the model is sustainable to changes in all initial parameters, even within the proposed option of transferring all patients from duvelisib to mosunetuzumab monotherapy will lead to a savings in current costs (2.9 %). Conclusions. The use of mosunetuzumab as a 3 rd and subsequent line therapy in adult patients with relapsed or refractory follicular lymphoma is an economically feasible approach within the Russian healthcare framework.