Center for Hematology and Oncology, Cologne, Germany.
Amgen Limited, Uxbridge, UK.
J Med Econ. 2021 Jan-Dec;24(1):114-122. doi: 10.1080/13696998.2020.1867469.
To assess the real-world healthcare resource utilization (HRU) and costs associated with different proteasome inhibitors (PIs) for the treatment of patients with relapsed and/or refractory multiple myeloma (RRMM) in Germany.
We conducted a retrospective medical chart review of treatment patterns, outcomes, and HRU for patients with RRMM treated with bortezomib, carfilzomib, or ixazomib in second- or third-line (2L or 3L) therapy in Germany. Data were collected between 1 January 2017 and 30 June 2017. Costs were calculated based on drug prices and unit costs in Germany.
Physicians provided data on 302 patients. Mean monthly total direct costs per patient receiving PI-based therapy were €7,925 and €10,693 for 2L and 3L, respectively, of which approximately 90% was anti-myeloma drug costs. Overall, the highest costs were associated with patients receiving 3L therapy. Regardless of treatment line, costs were higher for patients who had received a stem cell transplant (SCT) in a previous treatment line than for those who had not; the data suggest that this reflects the use of triplet regimens following a SCT. Patients with a complete response (CR) experienced no unplanned hospitalizations during the study period, whereas patients with progressive disease experienced the highest number of unplanned and planned hospitalizations. In 2L therapy, the highest proportion of patients with a CR was observed in those receiving carfilzomib (12% carfilzomib; 4% bortezomib; 0% ixazomib).
Patients with missing or incomplete follow-up data were included in the study and were accounted for using monthly cost estimates.
Anti-myeloma drugs were the main contributor to total HRU costs associated with RRMM in Germany. Improved treatment response was associated with lower costs and reduced hospitalizations.
评估在德国，用于治疗复发和/或难治性多发性骨髓瘤（RRMM）患者的不同蛋白酶体抑制剂（PI）的实际医疗资源利用（HRU）和成本。
我们对德国接受硼替佐米、卡非佐米或伊沙佐米二线或三线（2L 或 3L）治疗的 RRMM 患者的治疗模式、结局和 HRU 进行了回顾性病历审查。数据收集时间为 2017 年 1 月 1 日至 2017 年 6 月 30 日。成本根据德国的药物价格和单位成本计算。
医生提供了 302 名患者的数据。接受 PI 治疗的患者每月的总直接费用分别为 7925 欧元和 10693 欧元，用于 2L 和 3L，其中约 90%是抗骨髓瘤药物成本。总体而言，接受 3L 治疗的患者的费用最高。无论治疗线如何，在前一线治疗中接受过干细胞移植（SCT）的患者的成本都高于未接受过 SCT 的患者；数据表明，这反映了 SCT 后三联疗法的使用。在研究期间，达到完全缓解（CR）的患者没有计划外住院，而疾病进展的患者计划外和计划内住院次数最多。在 2L 治疗中，接受卡非佐米治疗的患者中达到 CR 的比例最高（卡非佐米 12%；硼替佐米 4%；伊沙佐米 0%）。
研究中包括了缺少或不完整随访数据的患者，并使用每月成本估计值进行了统计。
抗骨髓瘤药物是德国 RRMM 相关总 HRU 成本的主要贡献者。治疗反应的改善与成本的降低和住院次数的减少有关。
