Healthcare costs of multiple myeloma: an Italian study

Koleva, Daniela; Cortelazzo, Sergio; Toldo, C.; Garattini, Livio

doi:10.1111/j.1365-2354.2009.01153.x

Cited by 14 publications

(23 citation statements)

References 26 publications

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“…This provides a clear rationale for identifying and comparing treatment costs specific to rrMM 21 . As such, it is important to consider the total cost burden associated with MM treatment, including drug utilization, medical/diagnostic procedures, lab tests, and administration costs 33,34 .…”

Section: Discussionmentioning

confidence: 99%

“…Although the 12-month time frame is useful to compare the treatment regimens, since it reflects a common time frame of interest to US payers and captures the bulk of the duration of treatment for rrMM from initiation to relapse, it does not capture the entirety of clinical benefit received or costs incurred from either treatment 30,33,34 . At this time the evidence in the literature is not conclusive regarding whether extended TTP in rrMM translates into extended OS.…”

Section: Discussionmentioning

confidence: 99%

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Total cost comparison in relapsed/refractory multiple myeloma

Durie

Binder²,

Pashos³

et al. 2013

Journal of Medical Economics

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Objectives Advances in survival in multiple myeloma have focused payer attention on the cost of care. An assessment was conducted to compare the costs of two recent treatments for relapsed/refractory multiple myeloma (rrMM), from the perspective of a US payer. Methods An economic model estimated the total costs of care for two guideline-recommended therapies in rrMM patients: bortezomib (BORT) and lenalidomide plus dexamethasone (LEN/DEX). To evaluate total treatment costs, the costs associated with drug treatment, medical resource utilization, and adverse event (AE) management were determined for each regimen over a common 1-year period. Medical costs and grade 3/4 AE costs were based on rates from published literature, package inserts, and fee schedules (US dollars). To evaluate cost per outcome, assessments determined the monthly costs without disease progression based on pivotal clinical trials (APEX [BORT] and MM-009/MM-010 [LEN/DEX]). Univariate sensitivity analyses and alternative scenarios were also conducted. Results Drug costs for the treatments were very similar, differing by under $10 per day. Medical and AE management costs for BORT were higher by more than $40 per day. Treatment with BORT had annual excess total costs of >$17,000 compared with LEN/DEX. A cost advantage for LEN/DEX was maintained across a variety of sensitivity analyses. Total cost per month without progression was 11% lower with LEN/DEX. Limitations This analysis relied on separate studies having similar comparators, populations, and end-points. Actual treatment patterns and costs pre- and post-relapse may vary from the base scenario and sensitivities modeled. The 12-month time frame captures the preponderance of costs for a relapse line of therapy, yet may not reflect the entirety of costs. There is insufficient evidence to determine whether, or how, a difference in the lifetime costs of the two regimens would vary from the 1-year cost difference. Conclusion While rrMM treatment with BORT and LEN/DEX had comparable drug costs, total treatment costs for BORT were higher due to ongoing direct medical and AE management costs. Total costs per outcome (a month without disease progression) were lower for LEN/DEX.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Total cost comparison in relapsed/refractory multiple myeloma

Durie

Binder²,

Pashos³

et al. 2013

Journal of Medical Economics

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“…In contrast, the unit prices for BOR and LEN were similar in the U.S. and Europe, with ranges of €962. 34] for BOR and LEN in the U.S. Consequently, if the unit drug prices in the U.S. had been within the range of unit prices in Europe, the cost of care in the THAL cohort would have been lower given that drug costs represent a significant proportion of total health care spending. In addition, reimbursed amounts for other health care services and treatment patterns, such as site of care, likely differs between the U.S. and other countries.…”

Section: Discussionmentioning

confidence: 99%

“…However, only a limited number of studies have assessed the relative costs associated with these novel therapies and their cost-effectiveness compared with other therapeutic approaches [25][26][27][28][29][30][31][32][33][34][35][36][37]. In particular, very few studies have been conducted using real-world cost data and assessing the economic burden on patients.…”

Section: Introductionmentioning

confidence: 99%

Health Care Costs and Resource Utilization, Including Patient Burden, Associated With Novel-Agent-Based Treatment Versus Other Therapies for Multiple Myeloma: Findings Using Real-World Claims Data

et al. 2013

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Background. Treatment of multiple myeloma has dramatically improved with the introduction of bortezomib (BOR), thalidomide (THAL), and lenalidomide (LEN). Studies assessing health care costs, particularly economic burden on patients, are limited. We conducted a claims-based, retrospective analysis of total health care costs as well as patient burden (patient out-of-pocket costs and number of ambulatory/hospital visits) associated with BOR/THAL/LEN treatment versus other therapies (OTHER). Conclusions. Adjusted analyses of real-world claims data show that total health care costs, as well as patient out-of-pocket costs, are higher with THAL/LEN treatment episodes than with BOR/OTHER therapies. Additionally, similar rates of ambulatory visits suggest that any perceived advantage in patient convenience of the orally administered drugs THAL/LEN is not supported by these data. The Oncologist 2013;18:37-45 Implications for Practice: In addition to efficacy and safety considerations, economic factors associated with novel treatments are important issues for payers and patients. Claims data provide real-world insight into health care costs associated with treatment for multiple myeloma. In this study, total health care costs and patient out-of-pocket costs were measured during one year post-initiation and analyzed per treatment episode. Adjusted for patient characteristics, comorbidities, and line of treatment, the costs of "other" therapies (i.e., other chemotherapy or radiotherapy) and bortezomib were similar, but the costs of thalidomide or lenalidomide treatment were significantly higher. Despite different routes of administration for bortezomib (intravenous), and thalidomide and lenalidomide (oral), the number of ambulatory visits (i.e., clinic/physician office and hospital outpatient visits) appeared similar across therapies with the only significant difference being between the rates for lenalidomide and "other" treatment. These data show differential real-world costs and patient burden associated with these treatments and may support decision-making with regard to multiple myeloma treatment.

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“…Although several economic studies have analyzed the real-world healthcare costs associated with BORT and LEN, they have been conducted almost exclusively in the context of relapsed/refractory MM and mostly in populations outside of the United States 13,[16][17][18][19][20] . To our knowledge, the current analysis is the first to use real-world data to document and compare cost patterns specifically in patients with NDMM and patients with relapsed MM treated with LEN-or BORT-containing regimens, accounting for the full time period from therapy initiation through next therapy.…”

Section: Discussionmentioning

confidence: 99%