Paper Title
EVALUATING THE BUDGET IMPACT OF POLATUZUMAB + R-CHP AS A FIRST-LINE THERAPY FOR DLBCL IN THE UAE: A DYNAMIC MODEL ANALYSIS

Abstract
Background: The global incidence of hematologic malignancies has risen since 1990, reaching an age-standardized incidence rate (ASIR) of 5.73 per 100,000 in 20191. In the UAE, the ASIR for non-Hodgkin lymphoma (NHL) was 3.8 per 100,000 in 20222, with diffuse large B-cell lymphoma (DLBCL) accounting for 59% of cases3. While DLBCL treatment protocols are well documented, information on the budget impact of new therapies for DLBCL and relapsed/refractory (r/r) DLBCL is limited. Aim: This study estimated the incremental costs of treating DLBCL patients with Polatuzumab + R-CHP as a first-line regimen compared to the standard of care (SoC), focusing on new approaches for r/r DLBCL from a payer perspective in the UAE. It also examined the projected increase in CAR T-cell therapy over five years. Methodology: A dynamic budget impact model evaluated the financial implications of adding Polatuzumab + R-CHP to SoC, considering the projected use of CAR T-cell therapy. Direct medical costs, including administration and supportive care, were sourced from payer data. Population data were obtained from literature and local experts, while transition rates and adverse effects were derived from the POLARIX trial4. A univariate sensitivity analysis assessed model robustness. Results: Data from 178 UAE DLBCL patients showed that Polatuzumab + R-CHP would yield cost savings by the fourth year, with a net budget impact of approximately AED 3 million, AED 1.4 million, and AED -10 million for the first, third, and fifth years, respectively. Initial medication costs increase, but overall savings are anticipated due to reduced subsequent therapy needs. Conclusion: The model suggests that Polatuzumab as a first-line treatment for DLBCL could save costs in the UAE by reducing future therapy expenses. Keywords - Budget Impact Model, Economic Burden, Diffuse large B cell lymphoma, United-Arab-Emirates.