Objective Evaluate the effectiveness, safety, and cost-effectiveness of polatuzumab vedotin (Pola) in the treatment of diffuse large B-cell lymphoma (DLBCL) through rapid health technology assessment, providing reference for clinicians' medication choices and the formulation of medical insurance policies.

Methods Search databases such as PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data as well as official websites of international health technology assessment (HTA), to collect HTA reports, systematic reviews/Meta-analyses and pharmacoeconomic studies of Pola for the treatment of DLBCL.

Results A total of 18 studies were included, consisting of 6 Meta-analyses/systematic reviews and 12 pharmacoeconomic studies. None HTA reports were identified. In terms of efficacy, regimens containing Pola for DLBCL could significantly improve overall remission rate and prolong progression-free survival; however, there was no significant difference in overall survival. Regarding safety, the incidence of adverse events was significantly higher in the Pola treatment group compared with the control group, with a statistically significant difference. The most common adverse events were hematologic toxicities, including neutropenia, thrombocytopenia, and anemia. In terms of economics, with regard to the initial treatment of DLBCL, most analyses of pharmacoeconomic characteristics based on Western countries indicated that treatment regimens containing Pola offered a cost-effectiveness advantage over those without Pola, with their incremental cost-effectiveness ratios generally falling within acceptable thresholds; however, conclusions from domestic Chinese studies were mixed, and early studies based on Pola's high pricing prior to market launch and inclusion in the national health insurance scheme did not support the conclusion that it offered an economic advantage. In the treatment of relapsed or refractory DLBCL, regimens containing Pola were cost-effective, but not cost-effective compared with tafasitamab-lenalidomide.

Conclusion Treatment regimens including Pola show good safety and efficacy in DLBCL. Based on findings from overseas pharmacoeconomic studies, Pola demonstrates certain cost-effectiveness advantages. However, all existing domestic studies adopted the drug's price prior to its inclusion in the National Reimbursement Drug List in 2023. Affected by China's medical insurance reimbursement criteria, domestic healthcare cost composition and pricing benchmarks, its cost-benefit profile in Chinese patients differs substantially from that observed overseas. Following the completion of the drug's reimbursement access and price negotiation, its cost-effectiveness conclusion may undergo a fundamental shift. Therefore, localized re-evaluation based on the newly negotiated post-reimbursement price is urgently needed.

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