Belantamab Mafodotin, Pomalidomide, and Dexamethasone (BPd) in Relapsed/Refractory Multiple Myeloma (RRMM): Quality-Adjusted Life-Year (QALY) Results From a Cost-Effectiveness Model
Author(s)
Attaya Suvannasankha, MD1, Martin Kaiser, MD2, Dawn Lee, MMath, First Class3, Ewa Dlotko, MS4, Paul Macleod, BSc, MSc4, Natalie Boytsov, PhD5, Christina-Jane Crossman-Morgan, PhD6, Vinay Jadhav, M.Sc.7, Gbenga Kazeem, BSc, MPhil, DPhil8, Adil Merchant, BSc, MSc6, Molly Purser, MBA, PhD5, Justin Riemer, MBIOTECH9, Yevgeniy SAMYSHKIN, MSc6, Simon McNamara, BSc, MSc, PhD8;
1Indiana University School of Medicine and Roudebush VAMC, Indianapolis, IN, USA, 2The Institute of Cancer Research, London, United Kingdom, 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
1Indiana University School of Medicine and Roudebush VAMC, Indianapolis, IN, USA, 2The Institute of Cancer Research, London, United Kingdom, 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 DREAMM-8 (NCT04484623) trial demonstrated significant progression-free survival improvement with BPd vs pomalidomide-bortezomib-dexamethasone (PVd) in patients with RRMM who received ≥1 prior line of therapy including lenalidomide. A de novo cost-effectiveness model was developed and used to estimate QALYs associated with BPd vs alternative treatments for patients in second-line (2L) or later RRMM.
METHODS: A de novo partitioned-survival model composed of 4 health states (progression-free disease [PF] on-treatment, PF off-treatment, progressed disease, and death) evaluated BPd vs high-dose carfilzomib-dexamethasone (Kd), daratumumab-Kd (DKd), isatuximab-Kd, selinexor-Vd, Vd, PVd, and daratumumab-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 BPd and PVd were sourced from DREAMM-8 with relative treatment effects informed by a network meta-analysis. BPd drug usage was sourced from DREAMM-8 patient-level data to account for extended dosing frequency in 90% of patients. Comparator dosing and relative dose intensity was based on published data. DREAMM-8 EQ-5D-3L scores informed health state utilities. Adverse event disutilities were sourced from NICE appraisals. Sensitivity analyses (deterministic and probabilistic) were performed. The intent-to-treat (ITT) population was evaluated along with subgroups of lenalidomide-refractory and 2L patients.
RESULTS: For the ITT, BPd was associated with 3.3 QALYs and provided the highest life-years and QALYs among all compared treatments. QALYs for comparators ranged from 2.0 (Vd) to 3.1 (DKd). Similar results were observed in the lenalidomide-refractory and 2L subgroups, with BPd providing the highest QALYs among comparators. QALYs with BPd were 3.1 in lenalidomide-refractory and 5.2 in the 2L subgroups. Comparator QALYs ranged from 1.8 (Vd) to 2.8 (DKd) in lenalidomide-refractory patients and 3.5 (Vd) to 5.1 (DKd) in the 2L population.
CONCLUSIONS: BPd consistently provided higher QALYs vs comparator treatments across analyzed populations.
FUNDING: GSK
METHODS: A de novo partitioned-survival model composed of 4 health states (progression-free disease [PF] on-treatment, PF off-treatment, progressed disease, and death) evaluated BPd vs high-dose carfilzomib-dexamethasone (Kd), daratumumab-Kd (DKd), isatuximab-Kd, selinexor-Vd, Vd, PVd, and daratumumab-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 BPd and PVd were sourced from DREAMM-8 with relative treatment effects informed by a network meta-analysis. BPd drug usage was sourced from DREAMM-8 patient-level data to account for extended dosing frequency in 90% of patients. Comparator dosing and relative dose intensity was based on published data. DREAMM-8 EQ-5D-3L scores informed health state utilities. Adverse event disutilities were sourced from NICE appraisals. Sensitivity analyses (deterministic and probabilistic) were performed. The intent-to-treat (ITT) population was evaluated along with subgroups of lenalidomide-refractory and 2L patients.
RESULTS: For the ITT, BPd was associated with 3.3 QALYs and provided the highest life-years and QALYs among all compared treatments. QALYs for comparators ranged from 2.0 (Vd) to 3.1 (DKd). Similar results were observed in the lenalidomide-refractory and 2L subgroups, with BPd providing the highest QALYs among comparators. QALYs with BPd were 3.1 in lenalidomide-refractory and 5.2 in the 2L subgroups. Comparator QALYs ranged from 1.8 (Vd) to 2.8 (DKd) in lenalidomide-refractory patients and 3.5 (Vd) to 5.1 (DKd) in the 2L population.
CONCLUSIONS: BPd consistently provided higher QALYs vs comparator treatments across analyzed populations.
FUNDING: GSK
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE327
Topic
Economic Evaluation
Topic Subcategory
Trial-Based Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology