Introduction:
     
     This systematic review aims to explore the existing evidence on the cost-effectiveness of brexu-cel across different international jurisdictions.
   

Methods:
     
     A systematic search of articles on Embase, Medline, Econlit, Web of Science, Scopus, gray literature, and a manual search of HTA reports was done until 24 June 2024. Original English articles and reports from different countries assessing the cost-effectiveness of brexu-cel in relapsed/refractory acute lymphoblastic leukemia (R/R ALL) and mantle cell lymphoma (R/R MCL) were included. This review was registered in the Open Science Framework (OSF) registry.
   

Results:
     
     Of the 149 records, 22 articles underwent full-text review after the title and abstract screening, five met the inclusion criteria along with seven HTA reports from Australia, Canada, Scotland, and England. The CEA studies were from the US, England, Canada, and Italy, with varying perspectives, mainly adopting a partitioned survival model and lifetime horizons. The model input data from the ZUMA-2 and ZUMA-3 trials were used for brexu-cel, with comparisons from their respective trials or literature.
   

Conclusion:
     
     Brexu-cel was found cost-effective in all the CEA studies and an HTA report from Scotland, but the other HTA agencies reported uncertainties around the cost-effectiveness of brexu-cel for R/R ALL and R/R MCL.
   

Registration:
     
     Open Science Framework. (Reg doi: https://doi.org/10.17605/OSF.IO/JZU6Y).