Cost-Effectiveness Comparisons of Treatments for Heavily Pretreated Multiple Myeloma
The combination of pomalidomide and low-dose dexamethasone is more cost-effective for patients in the United States than either daratumumab or carfilzomib alone as treatment for relapsed or refractory multiple myeloma, according to research published by Sikander Ailawadhi, MD, of the Mayo Clinic, Jacksonville, Florida, and colleagues in Clinical Therapeutics.
Pomalidomide plus low-dose dexamethasone, daratumumab monotherapy, and carfilzomib monotherapy have all previously received U.S. Food and Drug Administration approval for use in the treatment of patients with heavily pretreated relapsed or refractory multiple myeloma.
The researchers designed computer-generated economic models to estimate the cost and health outcomes associated with each treatment over 3 years and three health states: progression-free, post–disease progression, and death.
Over 3 years, pomalidomide plus dexamethasone was associated with incremental gains in life-years and quality-adjusted life-years, with a cost less than that of daratumumab (–$8,919) and similar to that of carfilzomib (–$195). But when comparing cost alone in an equal efficacy scenario, the treatment combination was $11,799 less expensive than daratumumab and $12,595 less expensive than carfilzomib, the investigators revealed.