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Comparing Health-Care Costs Across Lines of Therapy for Multiple Myeloma

By: Joseph Fanelli
Posted: Tuesday, October 29, 2019

According to findings presented in Leukemia & Lymphoma, patients with multiple myeloma who receive drug therapy experience a “substantial” economic burden across all lines of therapy, and the cost of care has increased in the era of novel treatments for relapsed and refractory disease. May Hagiwara, PhD, of Policy Analysis Inc, Brookline, Massachusetts, and colleagues attributed the incremental cost of treating progressive multiple myeloma to hospitalizations and out-patients visits.

“Treatments that delay progression may yield important reductions in downstream disease management costs,” the authors concluded. “These savings should be considered in frameworks assessing the value of innovative treatments for [multiple myeloma].”

In this study, Dr. Hagiwara and colleagues collected data from 11,179 patients using the Truven Analytics MedStat MarketScan Commercial Claims and the Encounters and Medicare and Coordination of Benefits databases. They included all patients diagnosed with multiple myeloma from January 2006 to December 2016 and who had initiated at least one of several types of therapy. Annual health-care resource utilization and total health-care costs were calculated for each patient and each line of therapy.

For all lines of therapy, the mean annual hospitalization and health-care costs were higher for patients with disease progression than for those without. The difference in total incremental annual costs when comparing patients with and without disease progression were $25,920 for one line of therapy, $30,632 for two lines, $47,320 for three lines, and $19,769 for four lines.

The expected cumulative total plan costs were also higher for patients with disease progression, and the Kaplan-Meier’s sampling average for total health-care costs were $57,647 for one line of therapy, $58,941 for two lines, $58,293 for three lines, and $41,370 for four lines at 1-year post-index. The mean number of outpatient visits per year was also greater for patients with progressive disease in one through three lines of therapy.

Disclosure: Full disclosures of all study authors can be found at tandfonline.com.