Department of Pharmaceutical Economics and Policy, School of Pharmacy, Chapman University, Irvine, CA, USA.
College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
BioDrugs. 2022 Nov;36(6):773-780. doi: 10.1007/s40259-022-00557-3. Epub 2022 Sep 27.
Two chimeric antigen receptor-engineered T (CAR T) cell therapy drugs were recently approved for the treatment of patients with relapsed or refractory multiple myeloma (rrMM). Their financial impact, however, is poorly described.
The aim was to evaluate the economic burden of CAR T cell therapies ciltacabtagene autoleucel and idecabtagene vicleucel for the treatment of rrMM patients after at least four lines of therapy, and to compare the annual cost of these CAR T cell therapies over a hypothetical 1-million-member health plan from the US healthcare payer perspective.
The annual economic burden of ciltacabtagene autoleucel and idecabtagene vicleucel was estimated using data from pivotal clinical trials. The costs of drug acquisition, administration, and adverse event (AE) management were extracted from the IBM-Micromedex Red Book online, the Centers for Medicare & Medicaid Services fee schedules, and a review of the literature. We used descriptive statistics for the analysis.
The annual costs (US dollars) of drug acquisition, administration, and AE management per patient were $465,000, $60,167, and $40,368 and $419,500, $61,250, and $47,270 for ciltacabtagene autoleucel and idecabtagene vicleucel, respectively. The total annual cost was higher for ciltacabtagene autoleucel ($565,534) than for idecabtagene vicleucel ($528,020). However, the total annual cost in a hypothetical 1-million-member plan was less with ciltacabtagene autoleucel, by $1.8 million.
This study found that the CAR T cell gene therapies ciltacabtagene autoleucel and idecabtagene vicleucel for rrMM represent a significant economic burden for healthcare payers in the USA.
两种嵌合抗原受体工程 T 细胞（CAR T）疗法药物最近被批准用于治疗复发或难治性多发性骨髓瘤（rrMM）患者。然而，它们的经济影响描述得很差。
旨在评估至少接受四线治疗后接受 CAR T 细胞疗法 cilta-cabtagene autoleucel 和 idecabtagene vicleucel 治疗的 rrMM 患者的经济负担，并从美国医疗保健支付者的角度比较这些 CAR T 细胞疗法在假设的 100 万成员健康计划中的年度成本。
使用关键临床试验的数据来估算 cilta-cabtagene autoleucel 和 idecabtagene vicleucel 的年度经济负担。从 IBM-Micromedex Red Book 在线、医疗保险和医疗补助服务中心费用表以及文献综述中提取药物获得、管理和不良事件（AE）管理的成本。我们使用描述性统计数据进行分析。
每例患者的药物获得、管理和 AE 管理的年度费用分别为 465,000 美元、60,167 美元和 40,368 美元和 419,500 美元、61,250 美元和 47,270 美元，用于 cilta-cabtagene autoleucel 和 idecabtagene vicleucel。ciltacabtagene autoleucel 的总年度费用（565,534 美元）高于 idecabtagene vicleucel（528,020 美元）。然而，在一个假设的 100 万成员计划中，ciltacabtagene autoleucel 的总年度成本减少了 180 万美元。
这项研究发现，用于 rrMM 的 CAR T 细胞基因疗法 cilta-cabtagene autoleucel 和 idecabtagene vicleucel 对美国医疗保健支付者构成了重大的经济负担。
