Costs Associated with Productivity Loss Among U.S. Patients Newly Diagnosed with Multiple Myeloma Receiving Oral Versus Injectable Chemotherapy

Abstract

BACKGROUND: The use of novel drug agents in the treatment of multiple myeloma (MM) has been associated with improved therapeutic outcomes and survival; however, MM continues to pose a significant economic burden on patients and health care systems. Evaluating economic implications of therapies can provide key points of distinctions between available treatment options. Patients with MM may experience productivity loss, including lost days from work or inability to work due to MM symptoms or to undergoing treatment. Although direct costs of illness have been well described in the literature, indirect costs associated with MM are understudied. OBJECTIVE: To compare the extent of disability benefit use and resultant workplace productivity loss among U.S. adult patients with newly diagnosed MM who received oral versus injectable MM therapy.METHODS: A retrospective cohort study was conducted using the Truven Health Analytics MarketScan Commercial Claims and Encounters, Medicare Supplemental Coordination of Benefits, and Health and Productivity Management databases (2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015). Workplace absenteeism, as measured by disability benefit use, was evaluated 1 year before and 1 year after first MM diagnosis. Patients receiving only oral chemotherapy were compared with those who received injectable therapy. Absenteeism days and associated costs were compared among study groups using multivariable zero-inflated Poisson regression.RESULTS: The final study cohort included 299 patients with newly diagnosed MM, of whom 73 received oral therapy only and 226 received injectable therapy. Treatment type was a significant predictor of disability benefit use. Patients who received injectable therapy missed an average of 110 work days in the 1 year after diagnosis, compared with 87 for patients receiving only oral therapy (difference of 23 days, 95% CI = 19-26, P < 0.001). Treatment type was also a significant predictor of costs associated with lost productivity. Patients who received injectable therapy experienced productivity loss valued at $18,315, compared with patients who only received oral drug therapy

Ixazomib-based frontline therapy in patients with newly diagnosed multiple myeloma in real-life practice showed comparable efficacy and safety profile with those reported in clinical trial: a multi-center study

“…The ixazomib-based all-oral regimens, including IRd, ICd, and ITd, have demonstrated promising efficacy, safety, and tolerability in rigorously controlled clinical trials for NDMM [ 12 – 15 , 27 , 28 ]. Besides the greater convenience brought by the oral administration, the NDMM patients who received all-oral regimens have been shown to have lower economic burden of illness, less activity impairment, and lower productivity loss [ 29 ]. These facts together explained the reason for choosing ixazomib-based regimens as frontline therapy in selected real-world patients.…”

Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma

“…Requirements for long-term treatment approaches are summarized in Table 2 9,[14][15][16][17] . The key goals of long-term Table 1 Definitions of therapeutic approaches within the paradigm of long-term treatment.…”

“…•All-oral regimens have been shown to have lower economic burden of illness, less activity impairment, lower productivity loss, and a trend towards greater convenience than injectable regimens in the frontline setting 15,16 .…”

Healthcare resource utilisation and sickness absence in newly diagnosed multiple myeloma patients who did not undergo autologous stem cell transplantation: Trends in Sweden with the changing treatment landscape

“…Similar productivity loss costs were observed in our study, although we report this equated to an average 168 sickness absence days in the first year after diagnosis in Sweden. Merola et al 49 used an average US salary for all occupations in their estimates, whereas we calculated individual salary losses 31,49 . Another aspect of indirect economic cost to society is state‐funded early pension and, although not covered in this study, warrants further examination.…”

“…As age is a key factor in determining ASCT eligibility, workplace sickness absence impacts a minority of the non‐ASCT population; however, patients younger than 66 years of age at diagnosis represented 1269 patients (18% of total non‐ASCT cohort). In a US claims‐based study, Merola et al 49 reported an average 87‐100 days of sickness absence in newly diagnosed MM patients (<66 years old). Similar productivity loss costs were observed in our study, although we report this equated to an average 168 sickness absence days in the first year after diagnosis in Sweden.…”