Carfilzomib, in combination with lenalidomide and dexamethasone (KRd), may be a cost-effective treatment option for patients with relapsed or refractory multiple myeloma, according to the Kyprolis Global Economic Model (K-Gem).
The K-Gem is a robust framework for assessing the value of KRd in patients with myeloma. It was developed by a team of international experts over a number of years and has been used as the basis for a number of statutory Health Technology Assessment analyses around the world.
------
Related Content
ICER questions cost-effectiveness of multiple myeloma drugs
Cost-effectiveness of Afatinib Versus Erlotinib in the First-line Treatment of Patients with Metastatic Non-small Cell Lung Cancer with EGFR Exon 19 Deletion Mutations
------
In a study published in the Journal of Medical Economics, researchers led by Andrzej Jakubowiak, MD, PhD, University of Chicago Medicine (Chicago, IL), used data from the head-to-head phase 3 ASPIRE trial in a K-Gem to compare how total direct costs changed for patients treated with KRd and lenalidomide and dexamethasone (Rd) alone.
In the ASPIRE trial, results showed that treatment with KRd led to a significant improvement in median progression-free survival compared with Rd alone (26.3 months vs 17.6 months, respectively).
Using the K-Gem, KRd was estimated to be more effective than Rd, producing life year and quality-adjusted life year gains of 1.99 years and 1.67 years, respectively. In addition, KRd also demonstrated a cost-effectiveness ratio of $107,250
When that figure was contrasted with willingness-to-pay thresholds of $150,000-$300,000 per QALY—common benchmarks in the United States—researchers concluded that KRd provides significant value compared with Rd treatment alone.
However, the researchers did also note some limitations associated with the study, most notably the fact that extrapolated survival functions present the greatest uncertainty in modeled results. Also, utilities, though taken from a variety of sources, are only an assumption of how patients value their health state.
Carfilzomib is approved in the United States as a single agent and as part of a combination regimen with dexamethasone or lenalidomide plus dexamethasone for the treatment of patients with relapsed or refractory multiple myeloma who have already received 1 to 3 lines of therapy.
