Estimated impact of ECHELON-1 overall survival on productivity costs in stage III/IV classical Hodgkin lymphoma in the United States.

A 2010 study on the impact of cancer mortality on productivity costs found Hodgkin lymphoma to have the second largest productivity cost lost per death in the United States. The ECHELON-1 trial demonstrated that frontline brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (A+AVD) improves overall survival (OS) vs doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in stage III/IV classical Hodgkin lymphoma (cHL), reducing the risk of death to 41% (hazard ratio = 0.59; 95% CI = 0.40-0.88; = 0.009). To assess the estimated impact of frontline treatment choice on mortality and productivity using an oncology simulation model informed by ECHELON-1 data. Individual productivity was estimated using the human capital approach and reported via present value lifetime earnings (PVLE) estimates. Deaths avoided and lifeyears saved without and with A+AVD were calculated using a model informed by realworld treatment use, treatment-specific OS, and expert clinicians' opinions. A+AVD use in the base case was 27% (range: 0%-80%). Stage III/IV cHL prevalence over a 10-year period was estimated; downstream lifetime productivity costs were projected without and with A+AVD. In 2031, 3,645 patients were estimated to be newly diagnosed with stage III/IV cHL. Over 10 years with 27% A+AVD vs no A+AVD use, estimates predicted 14% fewer deaths (2,290 vs 2,650) and 14% less total PVLE losses ($1.438 vs $1.664 billion). Results from scenario analyses (40%-80% vs no A+AVD use) showed 20% to 32% decreases in PVLE losses ($1.331-$1.137 billion vs $1.664 billion), saving up to $527 million over 10 years. Productivity cost losses due to mortality in stage III/IV cHL are high. Increasing A+AVD use for patients with stage III/IV cHL would reduce productivity cost losses as deaths are avoided, based on ECHELON-1 OS results. This study is sponsored by Seagen Inc. Dr. Phillips is a consultant to AbbVie, ADC, AstraZeneca, Bayer, BeiGene, Bristol Myers Squibb, Epizyme, Gilead, Lilly, Pharmacyclics, Regeneron, Seagen Inc., and Xencor, and he is on the boards of Epizyme, Genentech, and Merck. Dr. Liu is an employee of Seagen Inc. and owns stock in Seagen Inc. Mr. Bloudek, Ms. Migliaccio-Walle, and Ms. Reynolds are employees of Curta and are paid consultants to Seagen Inc. in connection with this study. Dr. Burke has been a member of the speaker's bureaus at Seagen Inc. and BeiGene, and he is a consultant to AbbVie, Adaptive Biotechnologies, AstraZeneca, Bayer, BeiGene, Bristol Myers Squibb, Epizyme, Foresight Diagnostics, Genentech/Roche, Kura, Kymera, Lilly, MorphoSys, Novartis, Nurix, Seagen Inc., TG Therapeutics, Verastem, and X4 Pharmaceuticals.