Healthcare Costs Incurred by Patients with Multiple Myeloma Following Triple Class Exposure (TCE) in the US

Abstract

Introduction: Multiple myeloma (MM) is a malignancy of plasma cells; most MM patients will eventually relapse or become refractory to treatment. Treating MM patients remains a challenge since patients eventually progress through several lines of therapy (LOTs), requiring the use of multiple MM drug classes. We examined healthcare resource utilization (HCRU) and the costs incurred by MM patients following triple class exposure (TCE; defined as exposure to a proteosome inhibitor, an immunomodulatory agent, and an anti-CD-38 antibody). Methods: Adult MM patients were selected from the MarketScanÒ commercial and Medicare supplemental databases (January 2009-February 2021). From this cohort, patients who had TCE and C 1 subsequent LOT that occurred after January 1, 2017 were included in the study population. The initiation date for the first post-TCE LOT was defined as the index date. Allcause and MM-related HCRU and the associated costs were examined post-index date. Results: A total of 85 MM patients with TCE who initiated C 1 subsequent LOT post-TCE and had C 1 year of follow-up post-index date

Healthcare Costs of Multiple Myeloma Patients with Four or More Prior Lines of Therapy, Including Triple-Class Exposure in the United States

“…Approximately 88.5% of these costs were MM-related, with the majority (67%) of these costs largely attributed to MM drug and infusion costs ($450,952 per patient). These study findings are similar to those published previously among a larger sample of patients with MM who had TCE ( N = 85) where total all-cause healthcare costs averaged $34,578 PPPM over a 21-month follow-up, amounting to $722,992 per patient, of which approximately 91% were MM-related (MM drug/infusion costs: 66% of MM-related costs) [ 15 ].…”

“…The findings of Madduri et al also indicate that MM drug and infusion costs contributed over one-half of the monthly MM-related healthcare costs [ 16 ]. The findings of the current study, along with other published studies [ 15 , 16 ], show that patients with MM who had TCE and advance through multiple LOTs continue to incur high healthcare costs, primarily attributed to MM drug and infusion costs. The high monthly and total healthcare economic burden for this heavily pre-treated MM patient population underscores the possible value from newer treatment options for these patients.…”

“…This may have led to capturing some HCRU costs unrelated to MM; for example, patients with MM may have sought healthcare for other unrelated comorbidities and medical reasons and the providers may have included a diagnosis code indicating the patient had MM. However, this is a common method for identifying MM-related HCRU in health economics research studies [ 15 , 17 ]. In the case of the measurement of pharmacy fills (all-cause only), the data only reflect those filled by patients and may not capture all that were actually prescribed.…”

“…Treatment regimens and LOT definitions have been described in detail previously [ 15 ]. A summary of these methods is provided below.…”

“…In the Monoclonal Antibodies in Multiple Myeloma: Outcomes after Therapy Failure (MAMMOTH) study, median overall survival of TCE patients was 9.2 versus 11.2 months for patients who were refractory to only one other MM drug class; median overall survival further decreased to 5.6 months among TCE patients who were refractory to multiple PIs and IMiDs [ 14 ]. Previously, we assessed the healthcare costs incurred by patients with MM after they were TCE and had received at least one subsequent LOT [ 15 ]. In this follow-up study, we have specifically examined the healthcare costs of patients with MM who had received ≥ 4 prior LOTs, including TCE, to provide a better understanding of the potential value of new treatment options for these patients.…”