Dolph Mike, Tremblay Gabriel, Leong Hoyee
Health Economics Department, Purple Squirrel Economics, New York, NY, 10010, USA.
Health Economics and Outcomes Research, Global Medical and Scientific Affairs, Karyopharm Therapeutics, Newton, MA, 02459, USA.
Clinicoecon Outcomes Res. 2021 Jun 10;13:493-502. doi: 10.2147/CEOR.S305830. eCollection 2021.
To estimate the budget impact of selinexor, bortezomib, and dexamethasone (XVd) in patients with previously treated multiple myeloma (MM) from the perspective of a private third-party payer and Medicare in the US.
The introduction of XVd as an option for patients with previously treated MM compared to no introduction of XVd was considered from a private third-party US payer (with 1,000,000 members) and a Medicare perspective in one-year increments for 3 years. Total annual treatment costs were calculated as the sum of drug costs, costs of treating serious treatment emergent adverse events (grade ≥3), ongoing best supportive care costs, and mortality costs.
The absolute budget impact (Millions, USD) of including XVd from a private third-party payer plan perspective was $0.06, $0.07, $0.08 and $0.22 for years 1, 2, 3, and overall, respectively. The relative budget impact of including XVd was 0.33%, 0.40%, 0.43%, and 0.38% for years 1, 2, 3, and overall, respectively. This translated to a per member per month (PMPM) budget impact of $0.005, $0.006, $0.007, and $0.006 (USD), for years 1, 2, 3, and overall, respectively. From a Medicare perspective, the absolute budget impact (Millions, USD) of including XVd was $29.68, $36.62, $39.42 and $105.72 for years 1, 2, 3, and overall, respectively. The relative budget impact of including XVd was 0.33%, 0.40%, 0.43%, and 0.38% percent for years 1, 2, 3, and overall, respectively. This translated to a PMPM budget impact of $0.041, $0.051, $0.054, and $0.049 (USD), for years 1, 2, 3, and overall, respectively. Sensitivity analyses showed general consistency with the base-case findings.
Understanding the potential budget impact of new therapies in MM is vital for payers to manage spending and assess treatment value. The introduction of XVd presents a manageable budget impact for a third-party US payer and Medicare.
从美国私人第三方支付方和医疗保险的角度，评估塞利尼索、硼替佐米和地塞米松（XVd）对既往治疗的多发性骨髓瘤（MM）患者的预算影响。
从美国私人第三方支付方（拥有100万会员）和医疗保险的角度，以3年为期逐年考虑引入XVd作为既往治疗MM患者的一种选择与不引入XVd的情况。年度总治疗成本计算为药物成本、治疗严重治疗突发不良事件（≥3级）的成本、持续的最佳支持治疗成本和死亡成本之和。
从私人第三方支付方计划的角度来看，第1年、第2年、第3年及总体的XVd纳入绝对预算影响（百万美元）分别为0.06、0.07、0.08和0.22。第1年、第2年、第3年及总体的XVd纳入相对预算影响分别为0.33%、0.40%、0.43%和0.38%。这转化为第1年、第2年、第3年及总体的每月每位会员（PMPM）预算影响分别为0.005美元、0.006美元、0.007美元和0.006美元。从医疗保险的角度来看，第1年、第2年、第3年及总体的XVd纳入绝对预算影响（百万美元）分别为29.68、36.62、39.42和105.72。第1年、第2年、第3年及总体的XVd纳入相对预算影响分别为0.33%、0.40%、0.43%和0.38%。这转化为第1年、第2年、第3年及总体的PMPM预算影响分别为0.041美元、0.051美元、0.054美元和0.049美元。敏感性分析显示与基础案例结果总体一致。
了解MM新疗法的潜在预算影响对于支付方管理支出和评估治疗价值至关重要。XVd的引入对美国第三方支付方和医疗保险来说，预算影响是可控的。
