{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T20:34:48Z","timestamp":1793219688233,"version":"4.5.0"},"reference-count":28,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Burkitt lymphoma (BL) is a highly prevalent childhood cancer in sub-Saharan Africa. Outcomes are poor, with only 50% 2-year survival. Improving survival through intensifying chemotherapy treatment has proved challenging. Incorporating rituximab (a high-cost biological agent) into the current chemotherapy regimen is an alternative approach. A recent observational study in Tanzania and Uganda found improved 1-year survival, with no significant additional adverse events, when rituximab was added to chemotherapy. We present an economic evaluation of this regimen compared with current treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a cost-utility analysis from a Tanzanian health care perspective, over a patient lifetime, using a 4-state Markov model. Outcomes were measured in Disability-Adjusted Life Years (DALYs), and results were compared with three possible cost-effectiveness thresholds ($411 US dollars [USD], $1,211 USD and $3,633 USD). Survival, adverse events, and chemotherapy use came from the observational study (N = 72). Other resource used was derived from treatment protocols and clinical expertise, and unit costs (2023) were provided by Tanzanian hospitals. Survival was modeled parametrically over 2 years, after which survivors were assumed to be cured. We examined heterogeneity in cost-effectiveness by disease stage and performed sensitivity and scenario analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Adding rituximab gave an incremental cost-effectiveness ratio (ICER) of $483 USD per DALY averted, slightly above the most stringent of the thresholds considered, and would be considered cost effective at any threshold above $501 USD. Rituximab was particularly cost effective in advanced-stage disease (ICER $395 USD). Results were sensitive to discount rate, drug costs particularly rituximab, and disease progression assumptions. Budget impact was estimated as Tanzanian Shillings 866 million ($333,800 USD) annually, from 5 years after implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Adding rituximab to current chemotherapy is a plausibly cost-effective treatment that would save lives in childhood BL, particularly for advanced-stage patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-25-00752","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T19:59:16Z","timestamp":1788983956000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Addition of Rituximab to First-Line Treatment of Burkitt Lymphoma in Children and Young Adults in Tanzania: A Cost-Utility 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