Cost-effectiveness analysis on binary/triple therapy on the basis of ixazomib or bortezomib for refractory or relapsed multiple myeloma

A Systematic Review of Cost-Effectiveness Analyses of Novel Agents in the Treatment of Multiple Myeloma

“…Comparisons between regimens containing two novel agents resulted in 0.02 to 1.10 LYs and 0.01 to 0.91 QALYs gained. This comes with high costs: lifetime healthcare costs ranging from USD 60,413 to USD 1,434,937 per patient and incremental costs compared to backbone therapies ranging from dominated to USD 535,530 per patient [25][26][27][28][29][30][31][32][34][35][36][37][38] The ICERs we found were in only 12 (out of 32) comparisons beneath the generally accepted willingness-to-pay (WTP) threshold of USD 150,000 per QALY gained in the USA [25][26][27][28][29][30][31][32][33][34][35][36][37][38]56]. Three of these were comparisons between two novel treatment; thus, only nine comparisons were between a backbone therapy combined with a novel agent and a backbone therapy only.…”

“…However, higher WTP thresholds are reported by Health Technology Assessment (HTA) agencies (e.g., up to USD 95,072 in the Netherlands) [58]. Nevertheless, none of the ICERs per QALY gained (except for dominating regimens, i.e., Pano-Vd and comparisons between Pom-d and daratumumab monotherapy and Kd) fell below the WTP threshold of USD 34,097 [25][26][27][28][29][30][31][32][33][34][35][36][37][38]57] With the WTP threshold of USD 150,000 per QALY gained taken in account, compared with backbone therapies Vd and Rd, carfilzomib and panobinostat are below the WTP in most cases [29,31,[33][34][35]. The ICER per QALY gained of pomalidomide is below the WTP threshold against Kd, daratumumab monotherapy and HiDex [25,26,30].…”

“…All studies declared to have used empirical data for cost estimations (e.g., costs of adverse events, monitoring, administration and medicines), although the sources were not specified in the study of Gong et al [25][26][27][28][29][30][31][32][33][34][35][36][37][38] A lifetime horizon was reported in 10 studies with varying definitions with a maximum of 40 years [25,27,[29][30][31][32][33][34][35][36][37][38]. In contrast, Pelligra et al used a three-year time horizon because, according to them, it reflects a typical US payer's budget horizon and allows enough time to model clinically relevant outcomes appropriately [26].…”

“…We used the CHEERS checklist to assess quality and completeness of reporting of the studies. Most studies (12) scored well regarding reporting quality [26][27][28][29][30][31][32][33][34][35][36][37][38]. One study (Gong et al) was of a low quality [25].…”

Pegylated Liposomal Doxorubicin in Vindesine-Based and Bortezomib-Based Regimens for Patients With Newly Diagnosed Multiple Myeloma: A Retrospective Study of Efficacy and Safety

“…Multiple myeloma (MM) is a malignant tumor that ranks second among all hematological tumors worldwide ( 1 ). It is characteristic of abnormal proliferation of bone marrow plasma cells, production of clonal immunoglobulin, and destruction of the bones ( 2 ). Chemotherapy is the main therapeutic strategy for MM.…”