Studies from University of Washington Yield New Information about Multiple Myeloma (Cost-effectiveness of Drugs to Treat Relapsed/Refractory Multiple…

Insurance Weekly News

Studies from University of Washington Yield New Information about Multiple Myeloma (Cost-effectiveness of Drugs to Treat Relapsed/Refractory Multiple Myeloma in the United States)

By a News Reporter-Staff News Editor at Insurance Weekly News -- Investigators publish new report on Oncology - Multiple Myeloma. According to news reporting out of Seattle, Washington, by VerticalNews editors, research stated, "New 3-drug regimens have been developed and approved to treat multiple myeloma (MM). The absence of direct comparative data and the high cost of treatment support the need to assess the relative clinical and economic outcomes across all approved regimens."

Our news journalists obtained a quote from the research from the University of Washington, "To evaluate the cost-effectiveness of treatments for relapsed and/or refractory MM from a U.S. health system perspective. We developed a partition survival model with 3 health states (progression-free, progression, and death) to evaluate the following regimens: carfilzomib (CFZ), elotuzumab (ELO), ixazomib (IX), daratumumab (DAR), and panobinostat (PAN) in combination with lenalidomide (LEN) or bortezomib (BOR) plus dexamethasone (DEX) in the second and/or third line of therapy. To estimate relative treatment effects, we developed a network meta-analysis and applied progression-free survival hazard ratios to baseline parametric progression-free survival functions derived from pooled data on LEN+DEX. We estimated overall survival using data on the relationship between progression-free survival and overall survival from a large meta-analysis of MM patients. Modeled costs included those related to drug treatment, administration, monitoring, adverse events, and progression. Utilities were from publicly available data and manufacturer data, if published sources were unavailable. Model results showed that regimens containing DAR yielded the highest expected life years (DAR range: 6.71-7.38 vs. non-DAR range: 3.25-5.27) and quality-adjusted life-years (QALY; DAR range: 4.38-5.44 vs. non-DAR range: 2.04-3.46), with DAR+BOR+DEX (second line) and PAN+BOR+DEX (third line) as the most cost-effective options (incremental cost-effectiveness ratio: $50,700 and cost saving, respectively). The applicability of the PAN+BOR+DEX result may be challenging, however, because of ongoing toxicity concerns. In the probabilistic sensitivity analysis, second-line DAR+BOR+DEX and third-line PAN+BOR+DEX had an 89% and 87% probability of being cost-effective at the $150,000 per QALY threshold, respectively. The introduction of newer drugs and regimens to treat second-and third-line relapsed/refractory MM appears to provide clinical benefits by lengthening progression-free and overall survival and improving quality of life. However, only the addition of DAR or PAN may be considered cost-effective options according to commonly cited thresholds, and PAN+BOR+DEX results require cautious interpretation."

According to the news editors, the research concluded: "Achieving levels of value more closely aligned with patient benefit would require substantial discounts from the remaining agents evaluated."

For more information on this research see: Cost-effectiveness of Drugs to Treat Relapsed/Refractory Multiple Myeloma in the United States. Journal of Managed Care & Specialty Pharmacy, 2018;24(1):29-38,43-44. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

Our news journalists report that additional information may be obtained by contacting J.J. Carlson, University of Washington, Pharmaceut Outcomes Res & Policy Program, Seattle, WA 98195, United States. Additional authors for this research include G.F. Guzauskas, R.H. Chapman, P.G. Synnott, S.S. Liu, E.T. Russo, S.D. Pearson, E.D. Brouwer and D.A. Ollendorf.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.18553/jmcp.2018.24.1.29. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Keywords for this news article include: Seattle, Washington, United States, North and Central America, Hemic and Lymphatic Diseases and Conditions, Hematologic Diseases and Conditions, Vascular Diseases and Conditions, Immunoproliferative Disorders, Lymphoproliferative Disorders, Blood Protein Disorders, Hemorrhagic Disorders, Hemostatic Disorders, Drugs and Therapies, Health and Medicine, Multiple Myeloma, Paraproteinemias, Hematology, Oncology, University of Washington.