Cost effectiveness of polatuzumab for relapsed or refractory diffuse large B cell lymphoma in China using updated GO29365 trial data

Polatuzumab vedotin (Pola), a CD79b-targeting antibody-drug conjugate, was approved in China for use with bendamustine and rituximab (BR) in relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) patients ineligible for hematopoietic stem cell transplantation (HSCT). Previous study, based on immature survival data and without considering post-progression treatment costs, found Pola-BR not cost-effective. This study reassessed the cost-effectiveness of Pola-BR versus BR using mature survival data, updated drug prices, and total lifetime treatment costs. A partitioned survival model was developed from the Chinese healthcare system perspective, using updated GO29365 trial data and a mixture-cure approach for long-term survival. Costs included drug acquisition, administration, monitoring, adverse event management, and subsequent treatments. Outcomes were assessed as costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER), with a 5% discount rate. Sensitivity analyses tested result robustness. Pola-BR increased QALYs by 1.96 (3.30 vs. 1.34) at an additional cost of CNY 159,891, yielding an ICER of CNY 81,407 per QALY, below the willingness-to-pay threshold of CNY 89,358/QALY. Pola-BR also saved CNY 26,310 in subsequent treatment costs. In conclusion, Pola-BR is a cost-effective option for HSCT-ineligible R/R DLBCL patients in China.