OBJECTIVES

: To evaluate the saving healthcare and societal costs of Obinutuzumab in combination with Bendamustine followed by Obinutuzumab maintenance compared to Bendamustine alone in patients with refractory follicular lymphoma (FL) in hospitals in Ecuador.

METHODS

: The medical literature analysis of the clinical studies was performed to identify the main efficacy inputs of the therapeutic alternatives. The economic analysis of national data was performed from public repositories of drug prices, use recommendation status, public purchasing portal, national drug table. The perspective of the analysis was that of the state health care payer and, therefore, only costs directly related to the pharmacological treatment.

RESULTS

: Based on the GADOLIN study where it was identified that the median overall survival of the Obinutuzumab + Bendamustine combination was not identified at the end of the study, while Bendamustine monotherapy reached 53.9 months. The progression-free survival of the combination of Obinutuzumab + Bendamustine reached 25.3 months vs 14 months of Bendamustine monotherapy. The economic analysis was performed with a 6-year time horizon, where 10 new patients were included in each model year. The model simulates the patient's journey between the induction phase and the final maintenance phase with 20% dropout from treatment for different reasons. The additional investment that the state should make in this group of patients ranges from $ 15,000 to $ 20,000 per year per patient, depending on the treatment phase and the accumulation of cases, especially in year 3 and 5.

CONCLUSIONS

: Currently in Ecuador the recent approval of Bendamustine for the treatment of Lymphoma is a great step in the therapy of patients, however, the additional investment that the payer must make to increase the survival of these patients to almost double that obtained with the standard of treatment would justify the inclusion of Obinutuzumab gradually and if necessary through agreements between payers and manufacturing.