Evaluating the cost-effectiveness of the addition of rituximab to chemotherapy in the first-line treatment of Follicular Lymphoma patients in the UK

INTRODUCTION Follicular lymphoma (FL), a clinical subtype of Non-Hodgkin’s lymphoma (NHL) , develops slowly and often without symptoms for many years. In 2008, the incidence of FL in England and Wales was 3.4 per 100,000 persons. Over 70% of FLs are diagnosed in persons aged over 60 years, and 85-90% present with advanced disease, which is defined as lymph nodes on both sides of the diaphragm being involved (stage III) or disease is disseminated with one or more extra-lymphatic organs involved (stage IV). Advanced FL is not curable, thus the aim of disease management is to both increase patient life expectancy and to increase patient health-related quality of life. The objective of this study is to assess, from a UK NHS perspective, the cost-effectiveness of the addition of rituximab (R) to selected chemotherapies: CVP (cyclophosphamide, vincristine and prednisolone); CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) and MCP (mitoxantrone, chlorambucil and prednisolone) in the first-line treatment of follicular lymphoma.