Cost-effectiveness of Drugs to Treat Relapsed/Refractory Multiple Myeloma in the United States

Abstract

Funding for this work was provided in part by the Institute for Clinical and Economic Review, which collaborated on the design, conduct, and reporting of this evaluation. During the conduct of this study, Ollendorf, Synnott, Chapman, and Pearson report grants from Blue Shield of California Foundation, California Health Care Foundation, and Laura and John Arnold Foundation and also report other grants from Aetna, AHIP, Anthem, Blue Shield of California, CVS Caremark, Express Scripts, Harvard Pilgrim Health Care, OmedaRx, United Healthcare, Kaiser Permanente, Premera, AstraZeneca, Genentech, GlaxoSmithKline, Johnson & Johnson, Merck, National Pharmaceutical Council, Takeda, Pfizer, Novartis, Lilly, Spark Therapeutics, Sanofi, Prime Therapeutics, and Health Care Service Corporation outside the submitted work. Carlson reports grants from the Institute for Clinical and Economic Review during the conduct of the study and personal fees from Seattle Genetics, Genentech, and Pfizer outside the submitted work. Russo, Guzauskas, Liu, and Brouwer have nothing to disclose. Study concept and design were contributed by Carlson, Guzauskas, and Ollendorf. Guzauskas, Chapman, Synnott, and Liu collected the data, and Carlson, Guzauskas, Chapman, and Ollendorf contributed to data analysis, along with Synnott and Liu. The manuscript was written by Carlson, Guzauskas, and Brouwer, along with Chapman, Synnott, and Ollendorf, and revised by Carlson, Brouwer, and Guzauskas, along with Chapman, Synnott, and Ollendorf.

Custo-efetividade do esquema com daratumumabe, bortezomibe e dexametasona em comparação com terapias à base de carfilzomibe, elotuzumabe e ixazomibe para o tratamento de mieloma múltiplo recidivado e refratário na perspectiva de um pagador do sistema de saúde suplementar brasileiro

“…O presente estudo analisou, por meio de um modelo baseado no método de área sob a curva, a custo-efetividade do tratamento de pacientes com MMRR com o esquema DVd em comparação com os esquemas Kd, KRd, ERd e IRd na perspectiva de um pagador do sistema de saúde suplementar brasileiro. Os resultados demonstram que DVd apresenta melhores resultados de efetividade do que as terapias analisadas, o que condiz com dados disponíveis na literatura (Dimopoulos et al, 2017;Beurden-Tan et al, 2017;Carlson, 2018), além de ser a terapia menos custosa.…”

“…Os resultados encontrados nesse estudo corroboram a análise de custo-efetividade publicada para o cenário norte-americano (Carlson et al, 2018). Quando analisados os resultados de anos de vida ganho e custos, DVd também demonstrou benefícios de efetividade atrelada à economia de custos quando comparado com KRd, ERd e IRd tanto em segunda como em terceira linha de tratamento (o regime Kd não foi avaliado nesse estudo).…”

“…Nos Estados Unidos, um estudo avaliou a custo-efetividade dessas novas terapias, e um dos achados é que, dentre os tratamentos aprovados no Brasil, o esquema de combinação de daratumumabe, bortezomibe e dexametazona (DVd) é o mais custo-efetivo (Carlson et al, 2018).…”

Daratumumab vs pomalidomide for the treatment of relapsed/refractory multiple myeloma: A cost‐effectiveness analysis

“…The Institute of Clinical Effectiveness and Research previously conducted several cost-effectiveness analyses for these drugs, but did not include both daratumumab and pomalidomide in the same analysis, although they found that daratumumab-containing regimens are cost-effective compared to carfilzomib, elotuzumab, ixazomib, or panobinostat. 2 A recent manufacturer-sponsored analysis compared the cost-effectiveness of pomalidomide relative to daratumumab and carfilzomib, and showed that pomalidomide was marginally dominant (ie, cheaper and more effective) compared to both drugs. 3 Given that daratumumab and pomalidomide were not included in the same analysis in the reports published by the Institute of Clinical Effectiveness and Research, we sought to determine the costeffectiveness of daratumumab relative to pomalidomide from a US public payer perspective.…”

Health-related quality of life of carfilzomib- and daratumumab-based therapies in patients with relapsed/refractory multiple myeloma, based on German benefit assessment data

“…As a result, QoL has become an important determinant of therapy, with some physicians and patients choosing to optimize QoL at the cost of prolonged survival [20]. QoL is also a central component of health technology and cost-effectiveness assessment [21]. Incorporation of QoL endpoints in clinical trials is therefore essential to allow better clinical decisionmaking in patients with MM [22], including those with relapsed/refractory (RR) MM.…”