Assessing the treatment pattern, health care resource utilisation, and economic burden of multiple myeloma in France using the Système National des Données de Santé (SNDS) database: a retrospective cohort study

Abstract

Background Real-world data on health care resource utilisation (HCRU) and costs for French patients with multiple myeloma (MM) are limited due to the quickly evolving MM treatment landscape. This retrospective, national-level study quantified the MM economic burden in France. Methods The study included patients with newly diagnosed MM from the Système National des Données de Santé coverage claims database between 2013 and 2018 who received active treatment within 30 days of diagnosis. HCRU included hospitalisations, drugs, consultations, procedures, tests, devices, transport, and sick leave. Costs were annualized to 2019 prices. Drug treatments, reported by line of therapy (LOT), were algorithmically defined using drug regimen, duration of therapy, and gaps between treatments. Analyses were stratified by stem cell transplantation status and LOT. Results Among 6413 eligible patients, 6229 (97.1%) received ≥ 1 identifiable LOT; most received 1 (39.8%) or 2 LOT (27.5%) during follow-up. Average annual hospitalisation was 6.3 episodes/patient/year (median duration: 11.6 days). The average annual cost/patient was €58.3 K. Key cost drivers were treatment (€28.2 K; 39.5% of total HCRU within one year of MM diagnosis) and hospitalisations (€22.2 K; 48.6% of total HCRU costs in first year). Monthly treatment-related costs increased from LOT1 (€2.447 K) and LOT5 + (€7.026 K); only 9% of patients received LOT5 + . At LOT4 + , 37 distinct regimens were identified. Hospitalisation costs were higher in patients with stem cell transplantation than total population, particularly in the first year. Conclusions This study showed a high economic burden of MM in France (€72.37 K/patient/year in the first year) and the diversity of regimens used in late-line treatments.

Evolution of Pharmacological Treatments and Associated Costs for Multiple Myeloma in the Public Healthcare System of Catalonia: A Retrospective Observational Study

“…Lenalidomide, daratumumab, and bortezomib are the medicines with the highest expenditure. These results are similar to those observed in previous studies conducted in other European countries [21,22]. In 2015, there were four authorized treatment regimens in Europe that included lenalidomide, while in 2022, there were ten [9].…”

“…The primary objective of this study was to analyze the temporal evolution of prescription patterns and the pharmaceutical expenditure of medicines used in the treatment of MM within the public healthcare system of Catalonia over the past eight years. The mean age of the treated patients was 68.9 years, and there was a slight male predominance, consistent with previous studies [17,19,22,28]. The findings shed light on the increased prevalence of MM patients receiving treatment, the increased utilization of combinations and new drugs, and the increase in associated costs.…”

“…However, available studies describing MM treatment costs in earlier periods also showed progressive yearly increases [17,20], and multiple studies assessing MM healthcare resource utilization found that medicines were a key cost driver in any line of treatment [18,19,21,[47][48][49][50]. The mean cost per patient in a healthcare resource utilization study conducted in France was EUR 61,500 [22], almost EUR 10,000 lower than the figure reported here (EUR 70,816). However, the patient characteristics and analyzed periods are not comparable, as the French study included patients newly diagnosed with MM from 2013 to 2018 and followed them up for a median of 22 months, whereas our study included all MM patients treated from 2015 to 2022.…”

“…An analysis of MM pharmacological treatments could help characterize their use, costs, and the impact on the public healthcare budget. While some studies have described MM treatment patterns and costs [17][18][19][20][21][22], few of them included data after 2019 [22], and none were conducted in our setting. The detailed clinical and administrative data available in the region of Catalonia, providing universal coverage to 16% of the Spanish population, represents an opportunity to analyze valuable information [23].…”