Table 2.
Costs of drugs, monitoring, adverse-event management, and postprogression therapy
| Drugs | |||
|---|---|---|---|
| Cost per vial | Reference | ||
| Obinutuzumab (1,000 mg vial) | €1,659.56 | SORESA32 | |
| Rituximab SC branded (1,400 mg vial) | €1,219.18 | ||
| Bendamustine unbranded (100 mg vial) | €19.58 | ||
| Rituximab IV reference product (500 mg vial) | €992.00 | ||
| Rituximab IV biosimilar (500 mg vial) | €272.50 | ||
| Monitoring costs (follow-up from 30 months and during post-progression) | |||
| Frequency (monthly) | Unit cost | Reference (frequency/cost) | |
| Medical examination | 13% | €20.66 | AIOM7/Italian tariff34 |
| CT | 9% | €128.11 | |
| Blood exam | 13% | €22.47 | |
| Average monthly cost (per patient) | €17.64 | ||
| Postprogression costs | |||
| Share | Overall cost | Reference (share/cost) | |
| Allogeneic stem-cell transplant | 0.9% | €86,448 | EORTC study37/ Italian tariff34 |
| Autologous stem-cell transplant | 0.8% | €37,495 | |
| Chemotherapy | 4.6% | €1,803 | |
| Anti-CD20 (combo)/other | 55.0% | €10,194 | Roche data on file33/SPC and SORESA32 |
| Idelalisib monotherapy | 30.0% | €20,767 | Roche data on file33/Gopal et al39 and SORESA32 |
| Lenalidomide-based regimen | 5.0% | €54,171 | Roche data on file33/Leonard et al40 and SORESA32 |
| Radiotherapy | 2.3% | €3,316 | EORTC study37/AIMaC40 and Italian tariff34 |
| No intervention | 1.5% | — | EORTC study37 |
| Average overall cost of progression (per patient) | €15,739.38 | ||
| Adverse-event costs | |||
| Cost (per event) | Reference | ||
| Anemia | €1,323 | Mickisch et al41 | |
| Thrombocytopenia | €1,323 | ||
| Leukopenia | €1,802 | ||
| Neutropenia | €511 | ||
| Febrile neutropenia | €4,824 | Brown et al42 | |
| Dyspnea | €3,802 | Italian tariff34 (weighted mean by SDO43) | |
| Pneumonia | €3,194 | ||
Abbreviations: SC, subcutaneous; IV, intravenous; CT, computed tomography; SDO, Schede di Dimissione Ospedaliera.