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Advances in aggressive lymphoma from the 2018 American Society of Clinical Oncology annual meeting.

SUMMARY The Social Value of Tisagenlecleucel, a CAR-T Cell Therapy, for the Treatment of Relapsed or Refractory Pediatric Acute Lymphoblastic Leukemia in the United States: What Are Consequences of Treatment Delays? The social value of tisagenlecleucel treatment in pediatric patients with ALL in the United States was evaluated by obtaining estimates of life expectancy, quality-adjusted life years (QALYs), and health care costs (Abstract 10529). Each QALY gained was valued at $150,000, with a tisagenlecleucel price of $475,000. The analysis assumed that patients would receive treatment with clofarabine while awaiting treatment with tisagenlecleucel. Twenty incident cohorts included 500 pediatric patients with ALL. Patients treated with tisagenlecleucel gained 37,018 QALYs, reflecting a total social value of $4.6 billion. However, when treatment was delayed for 1 to 3 months, a loss of 3634 to 17,100 QALYs and $452 million to $2.1 billion of social value was incurred. When treatment was delayed by 4 months, over half of the social value, value to patients, and QALYs from tisagenlecleucel was lost. Treatment delays may be minimized by the development of efficient payment mechanisms and technologic resources.