Operational efficiencies and cost savings of using one bispecific antibody FDA-approved for both R/R 3L+ DLBCL and FL

Abstract

Abstract Background: Bispecific antibodies (bsAbs) have been approved for the treatment of relapsed/refractory (R/R) non-Hodgkin's lymphoma (NHL), including diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). Currently, epcoritamab is the only bsAb approved by the U.S. Food and Drug Administration (FDA) for both 3L+ R/R DLBCL and FL. This two-fold applicability presents a unique opportunity to streamline care by treating two indications with a single therapy. This study aimed to quantify the time and cost savings to oncology practices from using one bsAb for both indications compared with using two separate single-indication therapies. Methods: We conducted a national survey to assess changes in staffing time and resource use when prescribing a single bsAb for both 3L+ R/R DLBCL and FL, compared with using two separate single indication bsAbs. Respondents estimated impact on time and resources across key operational domains, including onboarding a new medication, coordinating insurance and financial aid, ordering and preparing medications for administration, and planning and providing treatment. Using these estimates, a cost consequence model was created and staff time savings at the practice level were monetized by multiplying the time saved by task, the frequency of each task and national average staff wages (U.S. Bureau of Labor Statistics (2025), Occupational Employment and Wage Statistics). The model incorporated direct financial cost savings from bulk medication purchasing and changes in drug wastage, enabling a comprehensive projection of first-year financial impact from using one FDA-approved bispecific antibody for both indications. Results: A total of 105 US oncology healthcare professionals participated in the survey (between 06/27 2025 and 07/07 2025), including 43 (41%) physicians, 42 (40%) advanced practice providers or nurses, and 20 (19%) pharmacists. Respondents represented academic (62%), community (26%), and private (12%) practice settings, with a mean of 13 years of oncology experience. Practices saw a median of 100 DLBCL/FL patients annually, and 88% reported experience using bsAbs to treat NHL. In the first year of adopting a single bsAb for both 3L+ R/R DLBCL and FL, respondents estimated that practices would save 20.67 hours per medication onboarded, 7.37 hours per new patient prescription, 5.35 hours per DLBCL administration, 5.26 hours per FL administration, and 6.21 hours in monthly ongoing reimbursement support and inventory management operations. For practices treating 100 bsAb eligible patients (assuming 61% DLBCL, 39% FL), with one new prescription per patient per year and administration frequencies of 12 visits per year for DLBCL patients and 15 visits per year for FL patients, this translates to a total time savings of 7,826 hours in the first year of adoption. Monetized time savings (based on worker wage rates) were estimated to be $2,246 per medication onboarded, $635 per new patient prescription, $491 per DLBCL administration, $483 per FL administration, and $630 per month for ongoing operations, resulting in total monetized time savings of $715,300. Direct financial cost savings were estimated at $192,501 from bulk purchasing and $55,086 from reduced medication waste, resulting in a total cost savings from monetized time savings and direct financial savings of $962,886 over the first year for 100 DLBCL/FL patients compared to using two single-indication bsAbs. For a hypothetical academic practice with 100 DLBCL/FL patients, total cost savings would be $1,210,661, versus $578,173 for a hypothetical community practice. Conclusions: Utilizing a single bispecific antibody for the treatment of both 3L+ R/R DLBCL and FL can yield substantial operational and financial benefits in terms of staff time and direct financial cost savings for oncology practices. This approach reduces complexity across clinical, educational, administrative, and procurement workflows, supporting a more streamlined, resource-efficient care model. As the only bsAb currently approved by the FDA for both R/R 3L+ DLBCL and FL, epcoritamab can deliver value not only through improved clinical efficacy but also by enhancing operational efficiency. These findings support the use of epcoritamab in DLBCL and FL as well as strategic adoption of multi-indication therapies NHL.