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已发表论文
在中国未经治疗的 CD20+弥漫性大 B 细胞淋巴瘤患者中，一线使用泽布替尼 -CHOP 方案与利妥昔单抗 -CHOP 方案的成本效益比较
Authors Gao L, Zhu H, Wang J, Lin Y , Ding B, Sun Y , Tao T, Li X
Received 14 July 2025
Accepted for publication 2 November 2025
Published 14 November 2025 Volume 2025:18 Pages 3621—3632
DOI https://doi.org/10.2147/RMHP.S553720
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Keon-Hyung Lee
Lihong Gao,1,2 Haomin Zhu,1 Jia Wang,3 Yingtao Lin,1,4,5 Baolong Ding,1 Yuyang Sun,1 Tiantian Tao,1 Xin Li2,3,5
1Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 2Department of Pharmacy, The Second People’s Hospital of Changzhou, Changzhou, Jiangsu, People’s Republic of China; 3Department of Health Policy, School of Health Policy and Management, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 4Clinical Medical Research Center, Fujian Cancer Hospital, Fuzhou, Fujian, People’s Republic of China; 5Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
Correspondence: Xin Li, Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China, Email xinli@njmu.edu.cn Tiantian Tao, Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China, Email tt-tao@njmu.edu.cn
Purpose: To conduct a cost-effectiveness analysis comparing zuberitamab combined with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone; Hi-CHOP) versus rituximab combined with CHOP (R-CHOP) as first-line therapy for previously untreated CD20-positive diffuse large B-cell lymphoma (DLBCL) patients in China.
Patients and Methods: A partitioned survival model (PSM) was developed to conduct a cost-effectiveness analysis of Hi-CHOP versus R-CHOP regimens in newly diagnosed CD20-positive DLBCL patients. The study utilized a 20-year time frame. Evaluated outcomes included overall survival (OS), quality-adjusted life-years (QALYs), total treatment costs, and incremental cost-effectiveness ratios (ICERs). The willingness-to-pay (WTP) threshold was defined as $40,334.05 per QALY, equivalent to triple China’s 2024 per capita GDP.
Results: The base-case analysis indicated that Hi-CHOP provided an additional 1.49 life-years and 1.57 QALYs compared to R-CHOP. The total treatment cost of Hi-CHOP was $238,164.77 higher than that of R-CHOP over 20 years, resulting in ICERs of $151,373.19 per QALY and $160,273.99 per life-year. One-way sensitivity analysis (OSA) identified progression-free survival (PFS) utility as the most significant parameter impacting model outcomes. Probabilistic sensitivity analysis (PSA) demonstrated that almost all simulated outcomes surpassed the WTP threshold. The cost-effectiveness acceptability curve (CEAC) demonstrated R-CHOP’s superior cost-effectiveness probability relative to Hi-CHOP across a WTP range from $0 to $150,000.
Conclusion: Given that Hi-CHOP is not cost-effective at conventional WTP thresholds, a substantial price reduction or unnecessary procedures, and optimizing clinical workflows for Hi-CHOP would be necessary to make it an economically viable first-line option for DLBCL compared to R-CHOP.
Keywords: cost-effectiveness, diffuse large b-cell lymphoma, quality-adjusted life years, zuberitamab, rituximab
1Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 2Department of Pharmacy, The Second People’s Hospital of Changzhou, Changzhou, Jiangsu, People’s Republic of China; 3Department of Health Policy, School of Health Policy and Management, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 4Clinical Medical Research Center, Fujian Cancer Hospital, Fuzhou, Fujian, People’s Republic of China; 5Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
Correspondence: Xin Li, Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China, Email xinli@njmu.edu.cn Tiantian Tao, Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China, Email tt-tao@njmu.edu.cn
Purpose: To conduct a cost-effectiveness analysis comparing zuberitamab combined with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone; Hi-CHOP) versus rituximab combined with CHOP (R-CHOP) as first-line therapy for previously untreated CD20-positive diffuse large B-cell lymphoma (DLBCL) patients in China.
Patients and Methods: A partitioned survival model (PSM) was developed to conduct a cost-effectiveness analysis of Hi-CHOP versus R-CHOP regimens in newly diagnosed CD20-positive DLBCL patients. The study utilized a 20-year time frame. Evaluated outcomes included overall survival (OS), quality-adjusted life-years (QALYs), total treatment costs, and incremental cost-effectiveness ratios (ICERs). The willingness-to-pay (WTP) threshold was defined as $40,334.05 per QALY, equivalent to triple China’s 2024 per capita GDP.
Results: The base-case analysis indicated that Hi-CHOP provided an additional 1.49 life-years and 1.57 QALYs compared to R-CHOP. The total treatment cost of Hi-CHOP was $238,164.77 higher than that of R-CHOP over 20 years, resulting in ICERs of $151,373.19 per QALY and $160,273.99 per life-year. One-way sensitivity analysis (OSA) identified progression-free survival (PFS) utility as the most significant parameter impacting model outcomes. Probabilistic sensitivity analysis (PSA) demonstrated that almost all simulated outcomes surpassed the WTP threshold. The cost-effectiveness acceptability curve (CEAC) demonstrated R-CHOP’s superior cost-effectiveness probability relative to Hi-CHOP across a WTP range from $0 to $150,000.
Conclusion: Given that Hi-CHOP is not cost-effective at conventional WTP thresholds, a substantial price reduction or unnecessary procedures, and optimizing clinical workflows for Hi-CHOP would be necessary to make it an economically viable first-line option for DLBCL compared to R-CHOP.
Keywords: cost-effectiveness, diffuse large b-cell lymphoma, quality-adjusted life years, zuberitamab, rituximab