OBJECTIVES: To investigate the budgetary impact of adopting epcoritamab for the recently indicated treatment of relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) after at least two lines of systemic therapy in Greece.

METHODS: A budget impact model was adapted from a public payer perspective to delineate the 3-year financial implications of introducing epcoritamab for the treatment of R/R DLBCL in the 3rd line+ treatment setting, alongside other available therapies (rituximab-based chemoimmunotherapy, polatuzumab vedotin with bendamustine plus rituximab, glofitamab, tafasitamab plus lenalidomide as well as the chimeric antigen receptor T-cell (CAR-T) therapies of axicabtagene ciloleucel and tisagenlecleucel). The model framework considered market share scenarios with and without epcoritamab and directly reimbursed costs of treatment (including drug acquisition, administration, monitoring, adverse events, and terminal care costs), all applied to the eligible Greek patient population. Resource use, unit costs and epidemiological data were retrieved from officially published sources, whereas the projected uptake of epcoritamab was provided by AbbVie Hellas. All cost inputs were indexed to 2024 euros. The primary measured outcome was the total budgetary impact, calculated by comparing the respective budget expenditures with and without epcoritamab in the market share mix scenarios.

RESULTS: Over the next 3 years, the total budgetary impact after the addition of epcoritamab to the original treatment mix was estimated at €2,107,127. The average annual total public expenditure for therapies in the world without epcoritamab was estimated at €9,018,406, whereas after the introduction of epcoritamab at €9,720,782, generating an average annual additional cost of €702,376. Sensitivity analyses corroborated the robustness of base case findings.

CONCLUSIONS: The budget impact analysis suggests that the reimbursement of epcoritamab for the treatment of patients with R/R DLBCL after at least two lines of systemic therapy would have a limited budgetary impact in Greece considering its promising clinical and administration benefits.