Cost Burden of Proteasome Inhibitors for Multiple Myeloma

A study published in the Journal of Medical Economics calculated costs associated with the use of different proteasome inhibitors (PI) for the treatment of patients with relapsed/refractory multiple myeloma (RRMM).

For this retrospective study, medical chart data was analyzed for 302 patients in Germany who were treated with PIs for RRMM in 2017. Treatment patterns, outcomes, and total health care costs were assessed for second- or third-line bortezomib, carfilzomib, or ixazomib regimens.

The mean monthly health care costs per patient were €7,925 and €10,693 for those receiving second- and third-line therapy, respectively. Approximately 90% of total monthly costs were attributable to drug costs. For the remaining costs, 43% were attributable to planned hospitalizations, 26% to unplanned hospitalizations, 14% to concomitant medications, and 7% to planned scans, tests, and other procedures.

Previous autologous hematopoietic cell transplantation (AHCT) was associated with increased costs, regardless of current treatment line. According to the study authors, this may reflect the prescription of triplet regimens following AHCT.

Patients who achieved a complete response (CR) to PI-based therapy experienced no unplanned hospitalizations. For those receiving second-line therapy, the highest proportion of CRs were achieved by patients treated with carfilzomib (12%), compared with 4% of the bortezomib cohort and no patients in the ixazomib cohort.

“This real-world study of health care resource utilization (HRU) and costs associated with patients with RRMM treated with PIs demonstrated that anti-myeloma drug costs are the main driver of total direct HRU costs in Germany,” wrote the authors in conclusion. “Regimens with second-generation PIs, such as carfilzomib, have the potential to increase response rates and prolong survival times, which may result in increased HRU and costs in the future. This, however, must be balanced with the potential savings associated with reduced hospitalizations and reduced treatment of adverse events.”