Abstract

To identify existing economic evaluations data for the treatment of relapsed/refractory multiple myeloma (RRMM) in UK. A de novo systematic literature review (SLR) was conducted in August 2019. Database searching using pre-determined search strategies was conducted in EMBASE, Medline, Medline (R) In-Process search strategy (via Embase.com) and the Cochrane library. In addition, grey literature search was performed. No treatment or date of publication restrictions were applied. A comprehensive quality assessment of each study identified was conducted using pre-defined guidelines. Of the initial 55 references, 11 met the economic evaluation criteria. The SLR identified six UK HTA appraisals, of which 4 assessed daratumumab against other interventions for the treatment of rrMM, one assessed ixazomib in combination with lenalidomide+dexamethasone in patients with at least one prior therapy and one re-assessed lenalidomide+dexamethasone in patients with one prior regimen of bortezomib. Five published studies in RRMM were also retrieved. Most references reported a partitioned survival model in a cost-utility analysis with a time horizon ranging from 15 years to a lifetime. Most studies were in patients with disease refractory to a proteasome inhibitor and an immunomodulatory agent or in patients who received atleast one line of prior therapy. Most economic evaluations assessed treatments used early in the MM pathway and applied partitioned survival models. No evaluations were retrieved in later stages of the disease (i.e. 5th line and beyond). Additional economic analyses need to be conducted for therapies addressing an unmet need once all therapeutic options have been exhausted.

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