Abstract
BackgroundIn Germany, several triplet therapies for treating relapsed or refractory multiple myeloma (rrMM) patients have recently been approved. While most of them are administered intravenously, ixazomib-based combination is the only orally bioavailable regimen.ObjectiveTo conduct a 1-year and 3-year budget impact analysis (BIA) of different novel triplets to treat patients with rrMM in second or subsequent therapy lines accounting for costs covered by German statutory health insurance (SHI).MethodsA 3-state partitioned survival model (PSM) was developed to evaluate the budget impact of the following regimens: carfilzomib plus lenalidomide plus dexamethasone (KRd), elotuzumab plus lenalidomide plus dexamethasone (ERd), daratumumab plus lenalidomide plus dexamethasone (DRd), and ixazomib plus lenalidomide plus dexamethasone (IRd). The analysis included direct medical costs such as drug acquisition, comedication and preparation for parenteral solutions, drug administration and other 1-time costs, adverse event management costs and direct non-medical costs, such as transportation costs.ResultsBased on current drug market shares in German healthcare market, the estimated costs after 1 year of treatment was €551 million (KRd), €163 million (ERd), €584 million (DRd), and €95 million (IRd). The total budget impact of €1393 million is mainly driven by drug acquisition and subsequent therapy costs.ConclusionAmong the regimens of interest, the oral-based therapy regimens offered cost advantages over intravenous-based therapy regimens. The higher overall costs of intravenous therapy regimens were attributed primarily to higher drug acquisition costs.
Highlights
Multiple myeloma (MM) is an incurable, heterogeneous blood cancer with serious disease-related complications accounting for 1% of all cancer diagnoses worldwide and (SIBE), Steinbeis University Berlin, Berlin, Germany13% of all hematologic malignancies [1]
It has been postulated that oral administration of anticancer drugs may contribute to improving patients’ quality of life (QoL), since oral administration avoids the inconvenience of infusions, the risk of infusion-related infections or extravasations, stress related to infusion, and the need for additional administration visits [7, 8]
Travel costs for administration of intravenous therapies are routinely covered by the German statutory health insurance (SHI)
Summary
Multiple myeloma (MM) is an incurable, heterogeneous blood cancer with serious disease-related complications accounting for 1% of all cancer diagnoses worldwide and (SIBE), Steinbeis University Berlin, Berlin, Germany13% of all hematologic malignancies [1]. Several new agents, such as the proteasome inhibitors (PIs) carfilzomib and ixazomib, and two monoclonal antibodies, elotuzumab and daratumumab, have been approved for the treatment of MM patients who received at least one prior line of therapy. Travel costs for administration of intravenous therapies are routinely covered by the German statutory health insurance (SHI) These differences may create disincentives in the use of oral therapies in rrMM patients within the German healthcare system. The aim of the present study was to conduct a budget impact analysis of the recently approved therapy regimens used in the treatment of rrMM patients accounting for costs covered by the German SHI. Objective To conduct a 1-year and 3-year budget impact analysis (BIA) of different novel triplets to treat patients with rrMM in second or subsequent therapy lines accounting for costs covered by German statutory health insurance (SHI). The higher overall costs of intravenous therapy regimens were attributed primarily to higher drug acquisition costs
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