PCN58 Estimation of Post-Infusion Costs of Care for Patients With Relapsed and Refractory Multiple Myeloma (RRMM) Who Received Idecabtagene Vicleucel (ide-cel, bb2121) in the KarMMa Clinical Trial

Abstract

Ide-cel, a BCMA-directed CAR T cell therapy has shown a favorable clinical benefit-risk profile in triple-class exposed patients with RRMM in the ongoing, phase 2, multicenter, single-arm KarMMa clinical trial (NCT03361748). This analysis evaluated healthcare resource utilization (HCRU) and estimated 1-year cost of care among patients treated within the KarMMa clinical trial. HCRU data were analyzed from the KarMMa clinical trial database, including hospital length of stay (LOS) (standard inpatient [IP] and intensive care unit [ICU] days), diagnostics, procedures, and medications. Data were analyzed from day of ide-cel infusion through 1-year of follow-up. Post-infusion costs were estimated using a micro-costing methodology. Unit costs were sourced from public databases or US health system (provider) perspective literature, adjusted to 2020 USD, and applied to each HCRU. Average total cost by ide-cel post-infusion month was calculated among patients with ongoing status in that month. Patients censored because of data cutoff were excluded. 128 patients received ide-cel infusions. Most patients received corticosteroids and antibiotics, 13.3% had vasopressor use. Few patients required dialysis (0.8%) or intubation (3.9%) and a minority (19.5%) had an ICU stay. Among all patients, mean (standard deviation [SD]) LOS was 21.4 (12.0) days for IP and 1.3 (3.4) days for ICU stays. Total LOS ranged between 15 to 114 days with a mean (SD) of 22.7 (12.5) days (protocol required IP stay ≥14 days). The estimated mean 1-year post-infusion total cost of care was USD 107,699. Most (58.0%) 1-year costs were incurred in the first month following infusion and were primarily driven by facility costs, namely standard IP and ICU stays. In the KarMMa clinical trial, most costs after ide-cel infusion were incurred during the first month and were related to facility use. Following the immediate infusion period, ide-cel was associated with significantly reduced HCRU and costs.