Cost-Effectiveness of the Addition of Rituximab to CHOP Chemotherapy in First-Line Treatment for Diffuse Large B-Cell Lymphoma in a Population-Based Observational Cohort in British Columbia, Canada

AbstractBackgroundDiffuse large B-cell lymphoma (DLBCL) has primarily been treated with cyclophosphamide, doxorubicin, vincristine, and predisone (CHOP) chemotherapy since the 1970s. Recently, the addition of rituximab to CHOP (CHOP-R) has been found to improve survival and trial-based results have suggested that it is a cost-effective alternative to CHOP.ObjectivesThe objective in this study was to evaluate the cost-effectiveness of CHOP-R relative to CHOP in first-line treatment of DLBCL in a population-based setting in British Columbia, Canada.MethodsWe created a patient-level simulation model describing potential pathways for DLBCL patients initiating treatment with either CHOP or CHOP-R. Model parameters were populated with statistical analyses of individual-level treatment and effectiveness data and published cost estimates. All results were stratified by age at treatment initiation (