Patients With Multiple Myeloma Incur High Health Care Costs During Follow-up

For patients with multiple myeloma (MM), the mean, total, all-cause health care cost during 21 months of follow-up was found to be nearly $723,000, an analysis of two large US administrative health care claims databases showed (Oncol Ther. 2021;9:659-669; doi:10.1007/s40487-021-00175-z)

“These study findings underscore the significant need to develop and make widely available other novel targeted therapies for the treatment of MM patients to potentially improve patient outcomes and reduce the health care economic burden of this patient population,” wrote Sundar Jagannath, MD, Icahn School of Medicine at Mount Sinai, New York, NY, and colleagues.

In the US, MM accounts for 10% of all blood cancers and 1.8% of newly diagnosed cancer cases. This translates into nearly 35,000 new diagnoses of MM estimated for 2021, which will result in 12,410 deaths.

Because most patients with MM eventually relapse or their cancer becomes refractory to treatment, these patients typically receive several lines of therapy (LOTs). These include proteasome inhibitors (PIs), immunomodulatory drugs, targeted monoclonal antibodies, the selective inhibitor of exportin-1, selinexor, and the antibody-drug conjugate belantamab mafodotin, which targets B-cell maturation antigen.

To better understand the value of new therapies for MM, Dr Jagannath and team selected adult patients with MM from the MarketScan commercial and Medicare supplemental databases. From this group, they selected patients who had received triple-class exposure (TCE) to a PI, an immunomodulatory drug, and an anti-CD-38 antibody and had also received at least one additional line of therapy from January 2017 through February 2021 for study inclusion. These patients also were required to have at least 1 year of follow-up after the date on which the additional line of therapy was begun, which was defined as the index date. The researchers then examined all-cause and MM-related health care resource utilization and associated costs after the index date by using descriptive statistics and SAS software, version 9.4.

As a result, the retrospective, observational, cohort study enrolled 85 patients with MM. In these study patients, the mean age was 59 years, and 60% of the group were men. During follow-up, 55 patients, or 65%, began a second line of therapy, and 30 patients, or 35%, received at least 3 lines of therapy, and mean, total, all-cause, health care cost per patient averaged nearly $35,000 monthly. Of total all-cause health care costs, about 91% were related to MM, and 66% of those costs stemmed from drugs or infusions. “In this real-world US study, MM patients with TCE incurred high health care costs, with the majority being MM related and primarily attributed to MM drug and infusion costs,” Dr Jagannath and team concluded, adding, “[T]he clinical benefits are diminished as patients continue to progress through multiple LOTs with shorter intervals between sequential LOTs, highlighting the unmet need in this patient population.”