Comparative cost per responder analysis of ciltacabtagene autoleucel and real-world standard of care therapy in patients with lenalidomide-refractory multiple myeloma.

Abstract

Background: Ciltacabtagene autoleucel (cilta-cel) is a chimeric antigen receptor T-cell therapy currently approved for relapsed/refractory multiple myeloma (RRMM). This study aimed to assess the value of cilta-cel against a real-world standard of care (RW-SoC) basket using a novel cost per responder (CPR) model.

Research design and methods: The model was aligned with the patient population in the CARTITUDE-4 trial and incorporated progression-free survival (PFS), post-progression survival (PPS), and death states. The base-case analysis was conducted from a mixed US payer perspective with a 36-month time horizon, and modeled outcomes included the total cost per treated patient, total cost per complete responder, and cost per month during PFS.

Results: In the base-case analysis, total cost per treated patient over 36 months was estimated to be lower for cilta-cel ($792,243) compared with RW-SoC ($815,023), with the difference driven predominantly by the lower costs for cilta-cel over the PPS period. Total costs per complete responder and per month during PFS were $1,070,599 and $25,203 for cilta-cel compared with $5,101,186 and $38,018, respectively, for RW-SoC.

Conclusions: The CPR model suggests that cilta-cel offers substantial clinical and economic benefit for patients with RRMM compared with RW-SoC therapies.