Real-world health care costs of relapsed/refractory multiple myeloma during the era of novel cancer agents
Version of Record online: 6 NOV 2012
© 2012 Blackwell Publishing Ltd
Journal of Clinical Pharmacy and Therapeutics
Volume 38, Issue 1, pages 41–47, February 2013
How to Cite
Gaultney, J. G., Franken, M. G., Tan, S. S., Redekop, W. K., Huijgens, P. C., Sonneveld, P. and Uyl-de Groot, C. A. (2013), Real-world health care costs of relapsed/refractory multiple myeloma during the era of novel cancer agents. Journal of Clinical Pharmacy and Therapeutics, 38: 41–47. doi: 10.1111/jcpt.12020
- Issue online: 2 JAN 2013
- Version of Record online: 6 NOV 2012
- Received 22 December 2011, Accepted 01 October 2012
- daily practice;
- multiple myeloma;
- novel agents;
What is known and objective: High costs of novel agents increasingly put pressure on limited healthcare budgets. Demonstration of their real-world costs and cost-effectiveness is often required for reimbursement. However, few published economic evaluations of novel agents for multiple myeloma exist. Moreover, existing cost analyses were heavily based on conventionally treated patients. We investigated real-world health care costs of relapsed/refractory multiple myeloma in Dutch daily practice.
Methods: A retrospective medical chart review was conducted for 139 patients treated between January 2001 and May 2009. Total monthly costs attributable to each cost component were described across all regimens and for bortezomib-, thalidomide- and lenalidomide-based treatment regimens.
Results: Mean monthly total costs (€3,981) varied depending on the sequence of therapy (range: €442–€31,318). Significant cost drivers across all regimens included costs of therapy and hospital admissions. The acquisition costs for novel agents in particular accounted for 32% of mean total monthly costs. Prognostic factors associated with increased mean total monthly costs in multivariate regression analysis included low platelet counts (P = 0·01) and worsening performance status (P < 0·001). Mean total monthly costs of bortezomib- and lenalidomide-based regimens were significantly higher than those for thalidomide-based regimens in second, third and fourth treatment line.
What is new and conclusions: Real-world costs during treatment of relapsed/refractory multiple myeloma vary greatly. Cost drivers include hospital admissions and acquisition costs of novel agents. Costs also vary by prognostic factors and treatment-related resource use. Future studies assessing the costs of combination therapy consisting of two or more novel agents are encouraged.