Multiple Myeloma in Portugal: Burden of Disease and Cost of Illness

Abstract

Background Multiple myeloma (MM) is the second most common hematological cancer worldwide and has significant morbidity and mortality and is increasing in incidence. While MM management costs are considerable, specific economic data at the country level remain scarce. Objective This study assesses the burden and cost of MM in Portugal from the perspective of the National Health Service (NHS) to support the definition of health policies, resource allocation and patient care. Methods Developed by the Portuguese Multiple Myeloma Group, this study considers the most recent available data. Burden of disease was measured using disability-adjusted life-years (DALYs). The cost of MM was estimated using a prevalence-based model that estimated direct costs for the NHS considering all costs associated with diagnosis, hospitalizations, surgeries, emergency visits, medical appointments, drugs and transportation. Costs were quantified based on the diagnosis-related group funding price, except for drug usage, which was calculated using the average hospital product stock price. Results The burden of disease attributable to MM for 2018 was estimated at 8931 DALYs: 8570 resulting from premature deaths and 361 from disability. Average yearly direct costs per patients with MM amounted to €31,449 (year 2018 values). Total direct costs are estimated at €61 million per year. Conclusions The mortality rate in MM means that most DALYs are due to years of life lost rather than years lost due to disability. This study generates comprehensive data on the burden and cost of MM in Portugal and provides updated insights into the costs associated with the management of MM.

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

“…The greatest costs were attributed to treatment and hospitalisation. This study extends findings of earlier research in Europe that reported lower HCRU costs for MM, but most used smaller cohorts or modelled data [ 14 , 16 , 26 , 27 ]. In one study reporting MM costs for 2018 in Portugal, the average overall annual MM cost burden per patient was lower (€31 K PPPY) than reported here (€58.3 K PPPY) [ 27 ].…”

“…This study extends findings of earlier research in Europe that reported lower HCRU costs for MM, but most used smaller cohorts or modelled data [ 14 , 16 , 26 , 27 ]. In one study reporting MM costs for 2018 in Portugal, the average overall annual MM cost burden per patient was lower (€31 K PPPY) than reported here (€58.3 K PPPY) [ 27 ]. Yet, the difference in the average annual cost of treatment administration was smaller (€28 K PPPY reported here vs €25 K PPPY reported in Portugal) and both studies show that the cost were mainly driven by the hospitalisations and treatments [ 27 ].…”

“…In one study reporting MM costs for 2018 in Portugal, the average overall annual MM cost burden per patient was lower (€31 K PPPY) than reported here (€58.3 K PPPY) [ 27 ]. Yet, the difference in the average annual cost of treatment administration was smaller (€28 K PPPY reported here vs €25 K PPPY reported in Portugal) and both studies show that the cost were mainly driven by the hospitalisations and treatments [ 27 ]. However, the Portuguese study was based on a lower number of patients than the current study ( n = 1941 vs n = 6413) and did not take into account costs associated with sick leave and invalidity.…”

The Burden of a Multiple Myeloma Diagnosis on Patients and Caregivers in the First Year: Western European Findings

“…Consultations with specialists and hospital visits or admissions explained most direct medical costs during the first year after diagnosis in this study, though the cost of treatments and medications were beyond the study scope. In the burden of illness study conducted by Neves et al 2021 37 in Portugal, pharmacological costs represented more than 60% of the direct medical costs, while hospital admissions that included a 9% transplant related in-hospital stays were the second largest component. The Portuguese authors calculated an average yearly direct costs per patients with MM of €31,449 (year 2018 values) with total direct costs amounting €61 million per year.…”

Healthcare Resource Utilization and Cost of Patients with Multiple Myeloma in Germany: A Retrospective Claims Data Analysis

“…Given this intricate disease course and the relatively wide array of therapeutic alternatives, it is increasingly important to understand the real-world economic burden of MM. Although several studies have demonstrated the costs associated with MM in the US and several European countries, far less is known about the economic burden associated with the real-world treatment of MM in Germany [17][18][19][20]. This study aims to bridge this gap by analyzing the healthcare resource utilization and costs in patients with MM, using claims data from a statutory sickness fund in Germany.…”