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Three treatment strategies were evaluated: (1) blinatumomab plus chemotherapy as first\u2010line therapy; (2) blinatumomab plus chemotherapy as second\u2010line therapy for patients who failed first\u2010line chemotherapy; (3) chemotherapy alone. Model outcomes included direct medical cost, life\u2010year gained (LYG), quality\u2010adjusted life\u2010year (QALY) gained and incremental cost\u2010effectiveness ratio (ICER). Comparing to the next less costly strategy, the ICERs of blinatumomab second\u2010line therapy (10\u2009534 and 12\u2009375 USD\/QALY) and blinatumomab first\u2010line therapy (50\u2009312 and 54\u2009799 USD\/QALY) were below the willingness\u2010to\u2010pay threshold (162\u2009721 USD\/QALY) for high and average risk of relapse groups respectively. One\u2010way sensitivity analysis found that exponential rates of survival with blinatumomab as first\u2010line and blinatumomab drug cost were influential factors. In probabilistic sensitivity analysis, blinatumomab first\u2010line group was the preferred option in 71.4% and 90.3% of simulations in the high and average risk of relapse groups, correspondingly. In conclusion, adding blinatumomab to first\u2010line therapy appears to be cost\u2010effective for paediatric patients with newly diagnosed standard\u2010risk B\u2010cell ALL.<\/jats:p>","DOI":"10.1111\/bjh.70582","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:55:44Z","timestamp":1779929744000},"page":"1146-1157","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Blinatumomab for treatment of children with acute lymphoblastic leukaemia in Hong Kong: A cost\u2010effectiveness analysis"],"prefix":"10.1111","volume":"209","author":[{"given":"Mingjun","family":"Rui","sequence":"first","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9874-8938","authenticated-orcid":false,"given":"Yin Ting","family":"Cheung","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"},{"name":"Hong Kong Hub of Paediatric Excellence The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Hong Kong Hub of Paediatric Excellence The Chinese University of Hong Kong  Hong Kong China"},{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"},{"name":"Department of Paediatrics and Adolescent Medicine Hong Kong Children's Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiran","family":"Wei","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingcheng","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaqi","family":"Shi","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Kong","family":"Li","sequence":"additional","affiliation":[{"name":"Hong Kong Hub of Paediatric Excellence The Chinese University of Hong Kong  Hong Kong China"},{"name":"Department of Paediatrics, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"},{"name":"Department of Paediatrics and Adolescent Medicine Hong Kong Children's Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce H. 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