Lin JK, et al. - Researchers examined the cost efficacy of two anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapies that are approved for diffuse large B-cell lymphoma, axicabtagene ciloleucel (axi-cel) and tisagenlecleucel; each costs $373,000. Data from recent multicenter, single-arm trials appraising axi-cel and tisagenlecleucel in multiply relapsed/refractory, adult, diffuse large B-cell lymphoma from a US health payer perspective over a lifetime horizon, were used in this decision analytic Markov model. They compared each therapy with salvage chemoimmunotherapy regimens and stem-cell transplantation under a range of plausible long-term effectiveness assumptions. Findings suggest the possibility of meeting a less than $150,000/QALY(quality-adjusted life years) threshold at 2018 prices with both CAR-T therapies. This depends on long-term outcomes compared with chemoimmunotherapy and stem-cell transplantation, which are unknown. Non-Hodgkin lymphoma health care costs might increase substantially with widespread adoption. Improvement in cost-effectiveness would occur with price reductions or payment for initial response, even with modest long-term outcomes.