Elranatamab Demonstrates Cost-Effectiveness Advantage Over Teclistamab in Advanced Myeloma
By: Wendy LaGrego
Posted: Monday, April 20, 2026
A recent economic evaluation by C. Botta, of the University of Palermo, Palermo, Italy, and colleagues, assessed the cost-effectiveness of elranatamab compared with teclistamab for patients with triple-class exposed relapsed or refractory multiple myeloma (TCE/RRMM) in Italy. The study addresses a critical unmet need in this heavily pretreated population, where outcomes remain poor and treatment costs are substantial. The results were reported in Cancers.
Study Details
The primary goal was to determine whether elranatamab, a BCMA-CD3 bispecific antibody, offers improved clinical and economic value relative to teclistamab from the perspective of the Italian National Health Service (NHS). The investigators developed a partitioned survival model incorporating three health states—progression-free survival, post-progression survival, and death—over a 25-year lifetime horizon. Clinical efficacy inputs for elranatamab were derived from the phase 2 MagnetisMM-3 trial, while outcomes for teclistamab were estimated using matching-adjusted indirect comparisons based on data from the MajesTEC-1 trial.
The model incorporated overall survival, progression-free survival, and time to treatment discontinuation, with extrapolation of survival curves beyond trial follow-up. Direct medical costs included drug acquisition and administration, disease management, adverse event management, and end-of-life care. Health utilities were derived from EQ-5D data within MagnetisMM-3, and both deterministic and probabilistic sensitivity analyses were conducted to test robustness. The model adhered to international health economic standards and applied a willingness-to-pay threshold of €33,004 per quality-adjusted life-year.
Key Takeaways
Results demonstrated that elranatamab was both more effective and less costly than teclistamab. Specifically, elranatamab yielded 3.31 life-years and 2.33 quality-adjusted life-years per patient, compared with 1.83 life-years and 1.27 quality-adjusted life-years for teclistamab. Total lifetime costs were significantly lower with elranatamab (€153,337 vs €224,610), resulting in savings of €71,273 per patient.
These findings translated into incremental gains of 1.48 life-years and 1.06 quality-adjusted life-years, with elranatamab classified as a dominant strategy. Cost differences were primarily driven by lower drug acquisition costs in the progression-free state. Sensitivity analyses confirmed the robustness of the findings, with nearly all probabilistic simulations demonstrating elranatamab’s dominance.
From a clinical perspective, these results highlight meaningful improvements in survival and quality-adjusted outcomes with elranatamab in a population with limited therapeutic options. The study also suggests that real-world cost savings may be even greater, given potential reductions in dosing frequency over time and durable responses observed in clinical practice.
The authors concluded: “From the Italian NHS perspective, elranatamab represents a clinically superior and economically favorable option for patients with TCE/RRMM. The obtained results support its value and sustainability within the national treatment landscape.”
