Cost of Anti-CD38 Monoclonal Antibodies in Combination With Bortezomib, Lenalidomide and Dexamethasone for the Frontline Treatment of Transplant-Ineligible Patients With Newly Diagnosed Multiple Myeloma in the US.

IF 2.3 Q2 ECONOMICS

Journal of Health Economics and Outcomes Research Pub Date : 2025-07-21 eCollection Date: 2025-01-01 DOI:10.36469/001c.141714

Niodita Gupta-Werner, Vipin Khare, Brian Macomson, Rohan Medhekar

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AnalySource® was utilized to access the First Databank drug pricing database to collect current US DACs. Drug administration time and costs were identified and weighted, assuming 40% and 60% received the drug in a hospital outpatient and community oncology setting, respectively. Total costs were calculated by adding DACs and drug administration costs. Results: The DAC was <math><mn>200</mn> <mrow><mo> </mo></mrow> <mn>866</mn> <mi>i</mi> <mi>n</mi> <mi>y</mi> <mi>e</mi> <mi>a</mi> <mi>r</mi> <mn>1</mn> <mi>a</mi> <mi>n</mi> <mi>d</mi></math> 137 434 in year 2 for daratumumab and <math><mn>212</mn> <mrow><mo> </mo></mrow> <mn>421</mn> <mi>i</mi> <mi>n</mi> <mi>y</mi> <mi>e</mi> <mi>a</mi> <mi>r</mi> <mn>1</mn> <mi>a</mi> <mi>n</mi> <mi>d</mi></math> 144 143 in year 2 for isatuximab. The DAC of daratumumab was <math><mn>18</mn> <mrow><mo> </mo></mrow> <mn>264</mn> <mo>(</mo> <mn>5.4</mn></math> 17 269 and <math><mn>17</mn> <mrow><mo> </mo></mrow> <mn>327</mn> <mi>l</mi> <mi>e</mi> <mi>s</mi> <mi>s</mi> <mi>t</mi> <mi>h</mi> <mi>a</mi> <mi>n</mi> <mi>I</mi> <mi>s</mi> <mi>a</mi> <mi>V</mi> <mi>R</mi> <mi>d</mi> <mi>i</mi> <mi>n</mi> <mi>p</mi> <mi>a</mi> <mi>t</mi> <mi>i</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>s</mi> <mo><</mo> <mn>75</mn> <mi>y</mi> <mi>e</mi> <mi>a</mi> <mi>r</mi> <mi>s</mi> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mo>≥</mo> <mn>75</mn> <mi>y</mi> <mi>e</mi> <mi>a</mi> <mi>r</mi> <mi>s</mi> <mi>o</mi> <mi>l</mi> <mi>d</mi> <mo>,</mo> <mi>r</mi> <mi>e</mi> <mi>s</mi> <mi>p</mi> <mi>e</mi> <mi>c</mi> <mi>t</mi> <mi>i</mi> <mi>v</mi> <mi>e</mi> <mi>l</mi> <mi>y</mi> <mo>.</mo> <mi>I</mi> <mi>n</mi> <mi>y</mi> <mi>e</mi> <mi>a</mi> <mi>r</mi> <mn>2</mn> <mo>,</mo> <mi>t</mi> <mi>h</mi> <mi>e</mi> <mi>t</mi> <mi>o</mi> <mi>t</mi> <mi>a</mi> <mi>l</mi> <mi>c</mi> <mi>o</mi> <mi>s</mi> <mi>t</mi> <mi>o</mi> <mi>f</mi> <mi>D</mi> <mi>V</mi> <mi>R</mi> <mi>d</mi> <mi>p</mi> <mi>e</mi> <mi>r</mi> <mi>p</mi> <mi>a</mi> <mi>t</mi> <mi>i</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>w</mi> <mi>a</mi> <mi>s</mi></math> 10 444 and <math><mn>10</mn> <mrow><mo> </mo></mrow> <mn>553</mn> <mi>l</mi> <mi>e</mi> <mi>s</mi> <mi>s</mi> <mi>t</mi> <mi>h</mi> <mi>a</mi> <mi>n</mi> <mi>I</mi> <mi>s</mi> <mi>a</mi> <mi>V</mi> <mi>R</mi> <mi>d</mi> <mi>i</mi> <mi>n</mi> <mi>p</mi> <mi>a</mi> <mi>t</mi> <mi>i</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>s</mi> <mo><</mo> <mn>75</mn> <mi>y</mi> <mi>e</mi> <mi>a</mi> <mi>r</mi> <mi>s</mi> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mo>≥</mo> <mn>75</mn> <mi>y</mi> <mi>e</mi> <mi>a</mi> <mi>r</mi> <mi>s</mi> <mi>o</mi> <mi>l</mi> <mi>d</mi> <mo>,</mo> <mi>r</mi> <mi>e</mi> <mi>s</mi> <mi>p</mi> <mi>e</mi> <mi>c</mi> <mi>t</mi> <mi>i</mi> <mi>v</mi> <mi>e</mi> <mi>l</mi> <mi>y</mi> <mo>.</mo> <mi>A</mi> <mi>c</mi> <mi>r</mi> <mi>o</mi> <mi>s</mi> <mi>s</mi> <mi>y</mi> <mi>e</mi> <mi>a</mi> <mi>r</mi> <mi>s</mi> <mn>1</mn> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mn>2</mn> <mo>,</mo> <mi>t</mi> <mi>o</mi> <mi>t</mi> <mi>a</mi> <mi>l</mi> <mi>c</mi> <mi>o</mi> <mi>s</mi> <mi>t</mi> <mi>o</mi> <mi>f</mi> <mi>D</mi> <mi>V</mi> <mi>R</mi> <mi>d</mi> <mi>p</mi> <mi>e</mi> <mi>r</mi> <mi>p</mi> <mi>a</mi> <mi>t</mi> <mi>i</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>w</mi> <mi>a</mi> <mi>s</mi></math> 27 713 and $27 880 less than IsaVRd in patients <75 years and ≥75 years old, respectively. 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引用次数: 0

Abstract

Background: The efficacy of the combination of bortezomib, lenalidomide, and dexamethasone with daratumumab (DVRd) or isatuximab (IsaVRd) for the frontline treatment of transplant-ineligible (TIE) newly diagnosed multiple myeloma (NDMM) has been demonstrated in clinical trials. However, the treatment cost for DVRd and IsaVRd has not been compared. Objectives: To compare the drug acquisition costs (DAC) of DVRd vs IsaVRd in the first 2 years of frontline treatment for TIE patients with NDMM in the United States. Methods: Dosing schedules from the CEPHEUS and IMROZ clinical US trials were used for this analysis. AnalySource® was utilized to access the First Databank drug pricing database to collect current US DACs. Drug administration time and costs were identified and weighted, assuming 40% and 60% received the drug in a hospital outpatient and community oncology setting, respectively. Total costs were calculated by adding DACs and drug administration costs. Results: The DAC was $200 866 i n y e a r 1 a n d$ 137 434 in year 2 for daratumumab and $212 421 i n y e a r 1 a n d$ 144 143 in year 2 for isatuximab. The DAC of daratumumab was $18 264 (5.4$ 17 269 and $17 327 l e s s t h a n I s a V R d i n p a t i e n t s < 75 y e a r s a n d \geq 75 y e a r s o l d, r e s p e c t i v e l y . I n y e a r 2, t h e t o t a l c o s t o f D V R d p e r p a t i e n t w a s$ 10 444 and $10 553 l e s s t h a n I s a V R d i n p a t i e n t s < 75 y e a r s a n d \geq 75 y e a r s o l d, r e s p e c t i v e l y . A c r o s s y e a r s 1 a n d 2, t o t a l c o s t o f D V R d p e r p a t i e n t w a s$ 27 713 and $27 880 less than IsaVRd in patients <75 years and ≥75 years old, respectively. Compared with isatuximab, treatment with daratumumab saves 36.13 and 22.17 hours of administration time in the first and second year, respectively. Discussion: This analysis shows that the DAC of DVRd is less than IsaVRd for the frontline treatment of TIE NDMM patients. DVRd results in time savings vs IsaVRd, which is preferable for patients and caregivers. Conclusions: DVRd is a timesaving and less expensive frontline treatment option for patients with TIE NDMM than IsaVRd in the first and second year of treatment.

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抗cd38单克隆抗体联合硼替佐米、来那度胺和地塞米松一线治疗美国新诊断的不适合移植的多发性骨髓瘤患者的成本

背景：硼替佐米、来那度胺和地塞米松联合达拉单抗（DVRd）或isatuximab （IsaVRd）一线治疗移植不合格（TIE）新诊断的多发性骨髓瘤（NDMM）的疗效已在临床试验中得到证实。然而，DVRd和IsaVRd的治疗费用尚未进行比较。目的：比较美国TIE合并NDMM患者一线治疗前2年DVRd与IsaVRd的药物获取成本（DAC）。方法：采用CEPHEUS和IMROZ美国临床试验的给药方案进行分析。利用AnalySource®访问First Databank药品定价数据库来收集当前的美国dac。确定并加权药物给药时间和成本，分别假设40%和60%的患者在医院门诊和社区肿瘤环境中接受药物治疗。总费用由DACs和药物管理费用相加计算。结果：1年的DAC为200866，达妥单抗2年的DAC为137434，异妥昔单抗2年的DAC为121221，达妥单抗2年的DAC为12421，达妥昔单抗2年的DAC为144143。达妥珠单抗的DAC分别为18 264(5.4 17 269和17 327)，在1 ~ 2岁之间，在1 ~ 2岁之间，在1 ~ 2岁之间，在1 ~ 5岁之间，在1 ~ 5岁之间，在1 ~ 5岁之间，在1 ~ 5岁之间，在1 ~ 5岁之间，在1 ~ 5岁之间，在1 ~ 5岁之间，在1 ~ 5岁之间，在1 ~ 5岁之间，在1 ~ 5岁之间，在1 ~ 5岁之间。我n y e r 2, t h e t o t l c o s t o f D V r D p e r p t e n t w s 10 444和553 l e s s t h n s V r D我n p t e n t s 75 y e r s n D≥75 y l e r s o D r e s p e c t I V e l y。在一线治疗TIE NDMM患者中，DVRd的DAC比IsaVRd低27713美元，比IsaVRd低27880美元。与IsaVRd相比，DVRd节省了时间，更适合患者和护理人员。结论：在治疗的第一年和第二年，与IsaVRd相比，DVRd是TIE NDMM患者节省时间和更便宜的一线治疗选择。

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