OBJECTIVES: Recent clinical trials have demonstrated that Inotuzumab ozogamicin (INO) has superior efficacy and safety compared with standard of care in patients with Relapsed or refractory B-cell acute lymphoblastic leukemia (R/R B-ALL). However, its economics remains unknown. The objective of this study was to explore the cost effectiveness of INO compared with blinatumomab in the treatment of Chinese adults with R/R B-ALL, and to provide evidence for relevant decision-makers in China.

METHODS: A five-state Markov model was developed to perform an economic evaluation comparing INO and blinatumomab from a Chinese healthcare payer’s perspective. The model adopted a lifetime horizon and a four-week cycle length, with a 5% discount rate for both costs and health outcomes. Efficacy data were derived from individual patient-level data in the INO-VATE study and published data in the TOWER study, and were adjusted by the method of match-adjusted indirect comparison (MAIC). Utility data were derived from values measured by the EQ-5D instrument in the INO-VATE study, cost data were derived from a real-world economic burden study conducted in 54 hospitals in China, and the remaining data were derived from published literature. Finally, deterministic sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA) were conducted to verify the robustness of the basic analysis results.

RESULTS: The results of base-case analysis showed that compared with blinatumomab, INO incurred a higher cost (¥841,829 vs. ¥761,901), and yielded more QALYs (2.317 vs. 1.181), resulting in an ICER of ¥70,383/QALY, which is lower than China’s one times per capita GDP (¥80,976/QALY). The PSA results indicated that at a willingness-to-pay threshold of 3 times the GDP in China, the probability of INO being cost effective was 100%.

CONCLUSIONS: INO appears to be a cost-effective strategy compared with blinatumomab for the treatment of adults with R/R B-ALL in China.