Lenalidomide maintenance after autologous hematopoietic stem cell transplantation (autoHSCT) is cost-effective compared to no maintenance therapy for patients with multiple myeloma (MM), according to a study published in the European Journal of Haematology (2020. doi:10.1111/ejh.13497).
“[autoHSCT] has improved progression‐free survival (PFS) and overall survival in eligible patients with newly diagnosed… [MM]; however, relapse occurs. Maintenance therapy with lenalidomide… extends survival, and delays relapse and the subsequent initiation of costly second‐line regimens,” explained Carin A Uyl‐de Groot, PhD, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Netherlands, and colleagues.
This analysis reports the cost-effectiveness of lenalidomide maintenance following autoHSCT from a Dutch health care perspective.
Researchers developed a partitioned survival model to assess the lifetime costs and benefits of lenalidomide maintenance for patients with MM. Efficacy was derived from a pooled meta-analysis of clinical trial data. Costs and subsequent therapy were derived from sources relevant to the Dutch market.
Overall, lenalidomide maintenance provided a quality-adjusted life year gain of 2.45 and a life year gain of 2.79 compared with no maintenance therapy. The cost of lenalidomide was partially offset by savings of €77,462 in subsequent treatment costs.
The incremental cost‐effectiveness ratio of lenalidomide maintenance was €30,143 compared to no maintenance therapy. Key model drivers included subsequent therapy, dosing schedule, and time horizon.
“Lenalidomide is cost‐effective after ASCT versus no maintenance therapy in the Netherlands. By extending PFS, lenalidomide delays the cost burdens associated with relapse and subsequent treatment lines,” Dr Uyl‐de Groot and colleagues concluded.—Janelle Bradley
