{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:08:17Z","timestamp":1792796897023,"version":"4.5.0"},"reference-count":39,"publisher":"American Society of Hematology","issue":"19","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,11,10]]},"abstract":"<jats:sec>\n                  <jats:title>Abstract<\/jats:title>\n                  <jats:p>The ZUMA-7 (Efficacy of Axicabtagene Ciloleucel Compared to Standard of Care Therapy in Subjects With Relapsed\/Refractory Diffuse Large B Cell Lymphoma) study showed that axicabtagene ciloleucel (axi-cel) improved event-free survival (EFS) compared with standard of care (SOC) salvage chemoimmunotherapy followed by autologous stem cell transplant in primary refractory\/early relapsed diffuse large B-cell lymphoma (DLBCL); this led to its recent US\u00a0Food and Drug Administration approval in this setting. We modeled a hypothetical cohort of US adults (mean age, 65 years) with primary refractory\/early relapsed DLBCL by developing a Markov model (lifetime horizon) to model the cost-effectiveness of second-line axi-cel compared with SOC using a range of plausible long-term outcomes. EFS and OS were estimated from ZUMA-7. Outcome measures were reported in incremental cost-effectiveness ratios, with a willingness-to-pay (WTP) threshold of $150\u2009000 per quality-adjusted life-year (QALY). Assuming a 5-year EFS of 35% with second-line axi-cel and 10% with SOC, axi-cel was cost-effective at a WTP of $150\u2009000 per QALY ($93\u2009547 per QALY). axi-cel was no longer cost-effective if its 5-year EFS was \u226426.4% or if it cost more than $972\u2009061 at a WTP of $150\u2009000. Second-line axi-cel was the cost-effective strategy in 73% of the 10\u2009000 Monte Carlo iterations at a WTP of $150\u2009000. If the absolute benefit in EFS is maintained over time, second-line axi-cel for aggressive relapsed\/refractory DLBCL is cost-effective compared with SOC at a WTP of $150\u2009000 per QALY. However, its cost-effectiveness is highly dependent on long-term outcomes. Routine use of second-line chimeric antigen receptor T-cell therapy would add significantly to health care expenditures in the United States (more than $1 billion each year), even when used in a high-risk subpopulation. Further reductions in the cost of chimeric antigen receptor T-cell therapy are needed to be affordable in many regions of the world.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1182\/blood.2022016747","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T20:06:31Z","timestamp":1659384391000},"page":"2024-2036","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":34,"title":["Cost-effectiveness of second-line axicabtagene ciloleucel in relapsed refractory diffuse large B-cell lymphoma"],"prefix":"10.1182","volume":"140","author":[{"given":"Swetha Kambhampati","family":"Thiruvengadam","sequence":"first","affiliation":[{"name":"1Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Saumoy","sequence":"additional","affiliation":[{"name":"2Center for Digestive Health, Penn Medicine Princeton Medical Center, Plainsboro, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yecheskel","family":"Schneider","sequence":"additional","affiliation":[{"name":"3St. Luke\u2019s University Health Network, Bethlehem, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Serrao","sequence":"additional","affiliation":[{"name":"4Division of Gastroenterology and Hepatology, Loma Linda University Health, Loma Linda, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pejman","family":"Solaimani","sequence":"additional","affiliation":[{"name":"4Division of Gastroenterology and Hepatology, Loma Linda University Health, Loma Linda, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1464-5494","authenticated-orcid":false,"given":"Lihua Elizabeth","family":"Budde","sequence":"additional","affiliation":[{"name":"1Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew G.","family":"Mei","sequence":"additional","affiliation":[{"name":"1Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8418-2811","authenticated-orcid":false,"given":"Leslie L.","family":"Popplewell","sequence":"additional","affiliation":[{"name":"1Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5292-8298","authenticated-orcid":false,"given":"Tanya","family":"Siddiqi","sequence":"additional","affiliation":[{"name":"1Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Zain","sequence":"additional","affiliation":[{"name":"1Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Forman","sequence":"additional","affiliation":[{"name":"1Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry W.","family":"Kwak","sequence":"additional","affiliation":[{"name":"1Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven T.","family":"Rosen","sequence":"additional","affiliation":[{"name":"1Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexey V.","family":"Danilov","sequence":"additional","affiliation":[{"name":"1Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9665-7415","authenticated-orcid":false,"given":"Alex F.","family":"Herrera","sequence":"additional","affiliation":[{"name":"1Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil R.","family":"Thiruvengadam","sequence":"additional","affiliation":[{"name":"4Division of Gastroenterology and Hepatology, Loma Linda University Health, Loma Linda, 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