Daratumumab may be the most cost-effective treatment option for patients with multiple myeloma (MM) compared with other novel therapies, according to a poster presented at the 2016 American Society of Clinical Oncology Annual Meeting (June 3-7; Chicago, IL).
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The US Food and Drug Administration approved daratumumab in late 2015 for the treatment of patients with MM who had received at least 3 prior lines of therapy, including a proteasome inhibitor and an immunomodulatory agent. To evaluate the cost-effectiveness of different therapeutic options available to this patient population, researchers developed a model to estimate the cost per median month of survival in patients treated with daratumumab, carfilzomib, and pomalidomide plus dexamethasone (POM+D).
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Researchers, led by Eric M Maiese, PhD, Johnson & Johnson (Philadelphia, PA), included pre- and post-medication, administration, monitoring auxiliary, and adverse event costs in their analysis. Drug costs were based on the Wholesale Acquisition Costs, with no discounting applied for the study. Monitoring, auxiliary, and adverse event costs were based on Medicare fee schedules and published data. Additionally, treatment duration was assumed to be median progression-free survival time.
Results of the study found that the cost per median month of survival was lowest when patients were treated with daratumumab ($4264). Carfilzomib was the drug associated with the next lowest cost, which was found to be $4884 in the FOCUS clinical trial and $4213 in the PZ-171-003-A1 trial, which was focused on a certain subgroup of patients with MM. PM+D was found to be the most expensive at $5536.
The most significant contributor to monthly costs was the price of the drug, followed by adverse event- and administration-related costs. Additional analysis revealed that carfilzomib had the lowest drug cost, but that daratumumab had lower monitoring and auxiliary costs and was also associated with fewer adverse events.
Researchers concluded that cost per median month of survival was lowest for daratumumab and carfilzomib and highest for POM+D. While the study was limited by its use of Wholesale Acquisition Costs, which might actually represent an overestimation of the costs to payers, results of the study can still help to support comprehensive health care decision-making for MM and provide a foundation for future economic analyses of MM treatments.
