Quality-Adjusted Life Year (QALY) Results From a Cost-Effectiveness Model for Belantamab Mafodotin, Bortezomib, and Dexamethasone (BVd) in Relapsed/Refractory Multiple Myeloma (RRMM)
Author(s)
Martin Kaiser, MD1, Attaya Suvannasankha, MD2, Dawn Lee, MMath3, Ewa Dlotko, MS4, Paul Macleod, BSc, MSc4, Natalie Boytsov, PhD5, Christina-Jane Crossman-Morgan, PhD6, Vinay Jadhav, MSc7, Gbenga Kazeem, BSc, MPhil, DPhil8, Connor Lloyd, MSc6, Molly Purser, MBA, PhD5, Justin Riemer, MBIOTECH9, Yevgeniy SAMYSHKIN, MSc6, Simon McNamara, BSc, MSc, PhD8;
1Royal Marsden, London, United Kingdom, 2, Indiana University School of Medicine and Roudebush VA Medical Center, Indianapolis, IN, USA, 3University of Exeter, Exeter, United Kingdom, 4FIECON, London, United Kingdom, 5GSK, Collegeville, PA, USA, 6GSK, London, United Kingdom, 7GSK, Bengaluru, India, 8GSK, Stevenage, United Kingdom, 9GSK, Mississauga, ON, Canada
1Royal Marsden, London, United Kingdom, 2, Indiana University School of Medicine and Roudebush VA Medical Center, Indianapolis, IN, USA, 3University of Exeter, Exeter, United Kingdom, 4FIECON, London, United Kingdom, 5GSK, Collegeville, PA, USA, 6GSK, London, United Kingdom, 7GSK, Bengaluru, India, 8GSK, Stevenage, United Kingdom, 9GSK, Mississauga, ON, Canada
OBJECTIVES: The phase 3 DREAMM-7 study (NCT04246047) demonstrated significant progression-free and overall survival improvement with BVd vs daratumumab-bortezomib-dexamethasone (DVd) in patients with RRMM who received ≥1 prior line of therapy. To measure the value of BVd vs alternative treatment options, a de novo cost-effectiveness model was developed to estimate total costs and QALYs for BVd vs viable comparator treatments in second-line or later RRMM.
METHODS: A de novo partitioned-survival model with 4 health states (progression-free disease on-treatment, progression-free disease off-treatment, progressed disease, and death) evaluated BVd vs 7 comparators: bortezomib-dexamethasone (Vd), DVd, pomalidomide-Vd, carfilzomib-dexamethasone (Kd), daratumumab-Kd (DKd), isatuximab-Kd, and selinexor-Vd. The model used a 1-week cycle length with a UK National Health Service and Personal Social Services perspective over a lifetime horizon, discounting outcomes at 3.5%. Efficacy data for BVd and DVd were sourced from DREAMM-7, while relative treatment effects for other comparators were informed by a network meta-analysis. Health utilities were informed by DREAMM-7 EQ-5D-3L data, and adverse event disutilities were sourced from previous NICE appraisals. Sensitivity analyses (deterministic and probabilistic) explored the level of uncertainty of the results. The overall intent-to-treat population was evaluated along with subpopulations (second-line, lenalidomide-refractory, lenalidomide-exposed).
RESULTS: In the intent-to-treat population, BVd resulted in the highest QALYs (6.5) among all treatments. QALYs for comparators ranged from 3.4 (Vd) to 5.4 (isatuximab-Kd). Similar results were observed in the subpopulations, with BVd resulting in the highest QALYs, and Vd and daratumumab-Kd providing the lowest and highest QALYs among comparators, respectively: second-line (BVd, 7.6; Vd, 5.3; DKd, 7.2); lenalidomide-refractory (BVd, 6.3; Vd, 2.4; DKd, 4.2); and lenalidomide-exposed (BVd, 4.8; Vd, 1.8; DKd, 3.0).
CONCLUSIONS: BVd consistently resulted in higher QALYs than comparators across all analyzed populations.
FUNDING: GSK
METHODS: A de novo partitioned-survival model with 4 health states (progression-free disease on-treatment, progression-free disease off-treatment, progressed disease, and death) evaluated BVd vs 7 comparators: bortezomib-dexamethasone (Vd), DVd, pomalidomide-Vd, carfilzomib-dexamethasone (Kd), daratumumab-Kd (DKd), isatuximab-Kd, and selinexor-Vd. The model used a 1-week cycle length with a UK National Health Service and Personal Social Services perspective over a lifetime horizon, discounting outcomes at 3.5%. Efficacy data for BVd and DVd were sourced from DREAMM-7, while relative treatment effects for other comparators were informed by a network meta-analysis. Health utilities were informed by DREAMM-7 EQ-5D-3L data, and adverse event disutilities were sourced from previous NICE appraisals. Sensitivity analyses (deterministic and probabilistic) explored the level of uncertainty of the results. The overall intent-to-treat population was evaluated along with subpopulations (second-line, lenalidomide-refractory, lenalidomide-exposed).
RESULTS: In the intent-to-treat population, BVd resulted in the highest QALYs (6.5) among all treatments. QALYs for comparators ranged from 3.4 (Vd) to 5.4 (isatuximab-Kd). Similar results were observed in the subpopulations, with BVd resulting in the highest QALYs, and Vd and daratumumab-Kd providing the lowest and highest QALYs among comparators, respectively: second-line (BVd, 7.6; Vd, 5.3; DKd, 7.2); lenalidomide-refractory (BVd, 6.3; Vd, 2.4; DKd, 4.2); and lenalidomide-exposed (BVd, 4.8; Vd, 1.8; DKd, 3.0).
CONCLUSIONS: BVd consistently resulted in higher QALYs than comparators across all analyzed populations.
FUNDING: GSK
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE282
Topic
Economic Evaluation
Topic Subcategory
Trial-Based Economic Evaluation
Disease
SDC: Oncology