Gilead and Kite Oncology announced new data from analyses of Yescarta® (axicabtagene ciloleucel), demonstrating its cost-effectiveness and budget impact compared to the current Standard of Care (SOC) in patients with large B-cell lymphoma (LBCL) who are refractory to or relapse within 12 months of first-line chemoimmunotherapy. These findings were presented at the European Hematology Association (EHA) meeting.

The analyses revealed several key points:

• Quality Adjusted Life Years (QALYs) and Costs: In the base-case analysis over a lifetime horizon, Yescarta-treated patients generated 8.24 discounted QALYs, compared to 6.52 QALYs for SOC patients, resulting in an incremental QALY gain of 1.72.

• Incremental Cost-Effectiveness Ratio (ICER): Compared to SOC, Yescarta demonstrated an ICER of S$75,910 (US$55,534) per QALY gained. This is below 1× GDP per capita of Singapore (S$113,779 [US$83,238] in 2023). According to the World Health Organization, a treatment strategy is considered highly cost-effective if the ICER is below 1× GDP per capita.

• Budget Impact: Introducing Yescarta to Singapore’s public healthcare system for second-line LBCL is expected to increase the annual budget impact by approximately 17%, from S$21.7 million (US$15.9 million) without Yescarta to S$25.4 million (US$18.6 million) with Yescarta in Year 5, during which peak usage is expected. This increase is mitigated by a reduction in subsequent treatment-related costs by S$9.3 million/year (US$6.8 million/year), from S$17.1 million/year (US$12.5 million/year) to S$7.8 million/year (US$5.7 million/year) in Year 5.

Diego Santoro, General Manager of the Intercontinental Region at Kite, commented on the significance of these findings: “The analyses demonstrate the cost-effectiveness of Yescarta in second-line treatment from the perspective of Singapore’s public healthcare system compared to bone marrow transplant. This marks an important step towards providing patients in Singapore with the option of CAR T-cell therapy earlier in their treatment journey, allowing for a more cost-effective allocation of resources and a manageable budget impact.”

The standard of care (SOC) for treating DLBCL patients has historically involved a multi-step process that starts with chemoimmunotherapy, followed by high-dose chemotherapy (HDT), and culminates with a stem cell transplant (ASCT). While approximately 60% of newly diagnosed LBCL patients respond to initial chemotherapy, about 40% will relapse or not respond, necessitating second-line treatment