{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:27:39Z","timestamp":1791646059955,"version":"4.3.4"},"reference-count":57,"publisher":"American Society of Hematology","issue":"5","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,3,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Follicular lymphoma (FL) is traditionally considered treatable but incurable. In March 2021, the US Food and Drug Administration approved the use of chimeric antigen receptor (CAR) T-cell therapy in patients with relapsed or refractory (R\/R) FL after \u22652 lines of therapy. Priced at $373\u2009000, CAR T-cell therapy is potentially curative, and its cost-effectiveness compared with other modern R\/R FL treatment strategies is unknown. We developed a Markov model to assess the cost-effectiveness of third-line CAR T-cell vs standard of care (SOC) therapies in adults with R\/R FL. We estimated progression rates for patients receiving CAR T-cell and SOC therapies from the ZUMA-5 trial and the LEO CReWE study, respectively. We calculated costs, discounted life years, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) of CAR T-cell vs SOC therapies with a willingness-to-pay threshold of $150\u2009000 per QALY. Our analysis was conducted from a US payer\u2019s perspective over a lifetime horizon. In our base-case model, the cost of the CAR T-cell strategy was $731\u2009682 compared with $458\u2009490 for SOC therapies. However, CAR T-cell therapy was associated with incremental clinical benefit of 1.50 QALYs, resulting in an ICER of $182\u2009127 per QALY. Our model was most sensitive to the utilities associated with CAR T-cell therapy remission and third-line SOC therapies and to the total upfront CAR T-cell therapy cost. Under current pricing, CAR T-cell therapy is unlikely to be cost-effective in unselected patients with FL in the third-line setting. Both randomized clinical trials and longer term clinical follow-up can help clarify the benefits of CAR T-cell therapy and optimal sequencing in patients with FL.<\/jats:p>","DOI":"10.1182\/bloodadvances.2022008097","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T18:05:11Z","timestamp":1667844311000},"page":"801-810","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":54,"title":["Cost-effectiveness of chimeric antigen receptor T-cell therapy in adults with relapsed or refractory follicular lymphoma"],"prefix":"10.1182","volume":"7","author":[{"given":"Kunal C.","family":"Potnis","sequence":"first","affiliation":[{"name":"1Yale School of Medicine, Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengyang","family":"Di","sequence":"additional","affiliation":[{"name":"2Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Isufi","sequence":"additional","affiliation":[{"name":"2Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lohith","family":"Gowda","sequence":"additional","affiliation":[{"name":"2Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart E.","family":"Seropian","sequence":"additional","affiliation":[{"name":"2Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7843-3162","authenticated-orcid":false,"given":"Francine M.","family":"Foss","sequence":"additional","affiliation":[{"name":"2Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT"},{"name":"3Department of Dermatology, Yale School of Medicine, Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3096-835X","authenticated-orcid":false,"given":"Howard P.","family":"Forman","sequence":"additional","affiliation":[{"name":"4Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, CT"},{"name":"5Department of Health Policy and Management, Yale School of Public Health, Yale University, New Haven, CT"},{"name":"6Yale School of Management, Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7071-6475","authenticated-orcid":false,"given":"Scott F.","family":"Huntington","sequence":"additional","affiliation":[{"name":"2Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT"},{"name":"7Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2023,3,3]]},"reference":[{"issue":"14","key":"2023081515553129800_bib1","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1182\/blood-2018-08-822148","article-title":"How I treat early-relapsing follicular lymphoma","volume":"133","author":"Casulo","year":"2019","journal-title":"Blood"},{"key":"2023081515553129800_bib2","unstructured":"National Cancer Institute\n          . 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