Health Economics
Lower Austria real-world DLBCL: modern therapies lift median OS to 20 months — at a steep cost
Real-world evidence usually answers two questions at once: does it help patients, and can systems afford it. This retrospective cohort from Lower Austria (2018–2022) compares outcomes in relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL) across “conventional” regimens versus exposure to “modern therapy” (keywords include CAR-T and bispecifics). The cleanest signal came from grouping patients by actual therapy exposure: median overall survival was 20 vs. 5 months (p = 0.022). The tradeoff is brutal: mean costs were €178,513.08 vs. €15,185.08, translating to an incremental cost of €10,889 per additional month of survival. The methodological note is the real takeaway for anyone reading “before/after approval” dashboards: calendar-based comparisons can mislead because new drugs don’t start and stop cleanly at EMA approval dates. The next step isn’t arguing about the value of innovation — it’s designing smarter sequencing and access rules that preserve the survival gain without turning oncology into an unlimited-credit-card problem.
Source: Cancer Medicine (PubMed 41735029)