ArticleCost effectiveness and resource allocation : C/E2026
Cost-effectiveness analysis of PET-guided BrECADD with chemotherapy in advanced-stage, classical Hodgkin lymphoma.
Article in Cost effectiveness and resource allocation : C/E, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02661503 (HD21 for Advanced Stages Treatment Optimization Trial in the First-line Treatment of Advanced Stage Hodgkin Lymphoma; Comparison of 6 Cycles of Escalated BEACOPP With 6 Cycles of BrECADD), which is not on this map. Not yet cited in PubMed.
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HD21 for Advanced Stages Treatment Optimization Trial in the First-line Treatment of Advanced Stage Hodgkin Lymphoma; Comparison of 6 Cycles of Escalated BEACOPP With 6 Cycles of BrECADD
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5 authors.
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Abstract
objectiveThe HD21 trial demonstrated efficacy and safety of brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, and dexamethasone (BrECADD) vs. bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (eBEACOPP) as frontline therapy for advanced-stage, classical Hodgkin lymphoma. This analysis evaluated the cost-effectiveness of BrECADD from a US healthcare payer perspective.
methodsBuilding upon a multicenter, randomized, open-label phase 3 HD21 trial (NCT02661503) that evaluated BrECADD versus eBEACOPP in advanced-stage, classical Hodgkin lymphoma patients, we constructed a Markov model with 3-week cycles over a 50-year horizon. The model's primary outcomes encompassed total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios, with all economic parameters discounted at 3.0% annually. Cost-utility analyses employed a willingness-to-pay threshold of $100,000 per QALY, supplemented by comprehensive sensitivity and scenario analyses to verify model robustness.
resultsEconomic evaluation demonstrated that compared to eBEACOPP, the BrECADD regimen yielded an additional 2.24 QALYs at an incremental cost of $113,134.17, producing an ICER of $50,411.69/QALY, substantially below the $100,000 WTP threshold. One-way sensitivity analysis identified BrECADD drug acquisition costs and health state utility values as the predominant model drivers; all ICERs remained below the $100,000 WTP threshold across the plausible ranges of all parameters. Probabilistic sensitivity analysis indicated that at a willingness-to-pay threshold of $100,000 per QALY, BrECADD was cost-effective compared to eBEACOPP in 100% of 1000 Monte Carlo iterations. The cost-effectiveness acceptability curve demonstrated that BrECADD achieved a greater than 50% probability of being cost-effective at WTP thresholds above approximately $55,000 per QALY.
conclusionsBrECADD can be considered a cost-effective treatment versus eBEACOPP in treating advanced-stage, classical Hodgkin lymphoma in America. CLINICAL TRIAL NUMBER: Not applicable.
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