评估 axi-cel 与挽救性免疫化疗随后进行高剂量化疗和自体干细胞移植 (HDT ASCT) 对于复发/难治性 (R/R) 大 B 细胞二线治疗有反应者的成本效益淋巴瘤（LBCL）。包含三种健康状态的分区生存混合治愈模型用于估计一生中累积的成本、获得的生命年（LYG）和质量调整生命年（QALY）。总生存期、无事件生存期以及下次使用 axi-cel 和 HDT ASCT 治疗的时间均来自 ZUMA-7 研究。总成本（欧元，2022 年）包括药物采购和管理、ASCT、后续治疗、疾病和不良事件管理以及姑息治疗。统一成本来自当地数据库和文献。成本和结果采用 3% 的折扣率。与 HDT ASCT 相比，axi-cel 为每位患者提供更高的 LYG（10.00 vs. 8.28 LYG/患者），并且为每位患者获得更高的 QALY（7.85 vs. 6.04 QALY/患者） 。使用 axi-cel 的终生总成本为 343,581 欧元/患者，而使用 IQT ASCT 的患者为 257,994 欧元/患者。 axi-cel 与 HDT ASCT 的增量成本效益比为 49,627 EUR/LYG，增量成本效用比为 47,309 EUR/QALY。敏感性分析证实了该模型的稳健性。在西班牙，Axi-cel 是 HDT ASCT 治疗 R/R DLBCL 的一种潜在的具有成本效益的替代方案。

To estimate the cost-effectiveness of axi-cel vs. salvage immunochemotherapy followed by high-dose chemotherapy and autologous stem-cell transplantation (HDT+ASCT) for responders to second-line treatment for relapsed/refractory (R/R) large B-cell lymphoma (LBCL).A partitioned survival mixture-cure model comprising three health states was used to estimate the costs, life years gained (LYG), and quality-adjusted life years (QALYs) accumulated over a lifetime horizon. Overall survival, event-free survival, and time to the next treatment with axi-cel and HDT+ASCT were derived from the ZUMA-7 study. The total costs (EUR, 2022) included drug acquisition and administration, ASCT, subsequent treatment, disease and adverse event management, and palliative care. The unitary costs were derived from local databases and the literature. A 3% discount rate was applied to the costs and outcomes.Compared with HDT+ASCT, axi-cel provided higher LYG per patient (10.00 vs. 8.28 LYG/patient) and greater QALYs gained per patient (7.85 vs. 6.04 QALY/patient). The lifetime total costs were 343,581 EUR/patient with axi-cel vs. 257,994 EUR/patient with IQT+ASCT. The incremental cost-effectiveness ratio of axi-cel vs. HDT+ASCT was 49,627 EUR/LYG, and the incremental cost-utility ratio was 47,309 EUR/QALY. Sensitivity analyses confirmed the robustness of the model.Axi-cel is a potentially cost-effective alternative to HDT+ASCT for the treatment of R/R DLBCL in Spain.