(302) Managed care approaches to bispecific antibodies (BsAbs) in follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL): AMCP Market Insights Program

Background: : BsAbs are a class of off-the-shelf therapies that activate immune cells by simultaneously targeting tumor antigens and T or natural killer cells. Compared to CAR T-cell therapy, BsAbs offer simpler logistics and promising clinical outcomes. In FL and DLBCL, BsAbs have shown efficacy in improving survival and reducing hospitalizations.

Objective: : Assess oncology experts’ perspectives on the use of BsAbs in FL and DLBCL; identify key challenges related to access, cost-effectiveness, and site-of-care; and outline best practices to support appropriate use and coverage decisions within managed care settings.

Methods: : A multidisciplinary roundtable of oncology experts from managed care organizations and cancer treatment centers was held in March 2025 to discuss the clinical integration, access challenges, and value considerations of BsAbs in FL and DLBCL. The program included polling questions to quantify participant perspectives and facilitated discussions to generate qualitative insights on managed care strategies and emerging best practices. A post-meeting survey confirmed participant agreement on health plan best practices proposed during the discussion.

Results: : Polling among 6 participants showed very high (17%) to high (83%) confidence in BsAbs’ clinical effectiveness for reducing mortality, adverse events, and hospitalizations in FL and DLBCL. Clinical efficacy was the top consideration when evaluating BsAbs (100%), followed by safety (57%), cost (57%), and site-of-care logistics (29%). Key challenges identified included lack of head-to-head studies (71%), site-of-care complexities (57%), and the need for long-term outcomes data (57%). Qualitative insights emphasized optimizing sequencing with other therapies, addressing geographic and socioeconomic disparities, and supporting outpatient management. The post-meeting survey showed strong agreement (weighted averages from 3.50 to 3.67 of 4) on 8 best practices including evaluating total cost of care, advancing outpatient administration models, and developing health plan policies for appropriate BsAb use and equitable access.

Conclusions: : Oncology experts recognize BsAbs as a promising treatment option for FL and DLBCL, with high confidence in their clinical value. Addressing challenges related to long-term data, cost-effectiveness, and site-of-care logistics will be critical to optimize their use. Program insights highlight actionable best practices for payers and the importance of supporting outpatient care models and promoting equitable access to maximize the clinical and economic benefits of BsAbs within managed care settings.

Sponsorship:: Genmab.