Cost-Utility Analysis of Sequential Therapy of iCT IRd and DRd strategy for Newly Diagnosed Multiple Myeloma Patients Who are Transplant-Ineligible in China
Author(s)
Genyong Zuo, PhD1, Yongbo Gao, Master2, Wendong Chen, PhD3, Wenming Chen, PhD4;
1Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, China, 2Medical Affairs, Takeda (China) International Trading Company, HEOR Associate Manager, Beijing, China, 3Institute of Hospital Management Research, Xiangya Hospital of Central South University, Changsha, China, 4Department of Hematology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China
1Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, China, 2Medical Affairs, Takeda (China) International Trading Company, HEOR Associate Manager, Beijing, China, 3Institute of Hospital Management Research, Xiangya Hospital of Central South University, Changsha, China, 4Department of Hematology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China
Presentation Documents
OBJECTIVES: The iCT IRd strategy (in-class transition from bortezomib-based induction regimens to ixazomib-lenalidomide-dexamethasone regimen) and the DRd strategy (daratumumab-lenalidomide-dexamethasone regimen as induction therapy and continuous therapy) are recommended for newly diagnosed multiple myeloma patients who are ineligible for stem-cell transplantation (NDMM). Previous real-world studies have shown that iCT IRd strategy offers better adherence, greater effectiveness, and superior safety than DRd strategy. This study aims to assess the cost-utility of iCT IRd strategy compared to DRd strategy for NDMM from the perspective of the Chinese healthcare payers.
METHODS: A cost-utility analysis (CUA) model was developed by integrating real-world evidence into Markov model to simulate the clinical pathway of NDMM under two strategies. Clinical, utility, and cost inputs were estimated from published literature and public data sources. The model employed a monthly cycle length and a lifetime horizon for simulations. Both quality-adjusted life years (QALYs) and direct medical costs were discounted at an annual rate of 5%. Deterministic and probabilistic sensitivity analyses were performed to address the robustness and uncertainty.
RESULTS: Compared with DRd strategy, iCT IRd strategy resulted in cost-effectiveness dominance indicated by an incremental health benefit of 0.554 QALYs (4.620 vs. 4.066 QALYs) and a lower total cost ($86,076 vs. $93,137). The uncertainty of the risk of treatment discontinuation of continuous therapy for iCT IRd strategy and DRd strategy could substantially impact CUA. The probabilities of iCT IRd strategy being cost-effective at willingness-to-pay thresholds of 1-, 2-, and 3-times China’s 2023 gross domestic products per capita ($12.7K) per QALY, were 75.9%, 85.1%, and 89.3%, respectively.
CONCLUSIONS: The iCT IRd strategy dominated DRd strategy for NDMM in China by gaining more health benefits and saving costs. The uncertainty of the CUA has limited impact on the cost-effectiveness dominance, supporting the use of iCT IRd strategy as a favorable treatment option.
METHODS: A cost-utility analysis (CUA) model was developed by integrating real-world evidence into Markov model to simulate the clinical pathway of NDMM under two strategies. Clinical, utility, and cost inputs were estimated from published literature and public data sources. The model employed a monthly cycle length and a lifetime horizon for simulations. Both quality-adjusted life years (QALYs) and direct medical costs were discounted at an annual rate of 5%. Deterministic and probabilistic sensitivity analyses were performed to address the robustness and uncertainty.
RESULTS: Compared with DRd strategy, iCT IRd strategy resulted in cost-effectiveness dominance indicated by an incremental health benefit of 0.554 QALYs (4.620 vs. 4.066 QALYs) and a lower total cost ($86,076 vs. $93,137). The uncertainty of the risk of treatment discontinuation of continuous therapy for iCT IRd strategy and DRd strategy could substantially impact CUA. The probabilities of iCT IRd strategy being cost-effective at willingness-to-pay thresholds of 1-, 2-, and 3-times China’s 2023 gross domestic products per capita ($12.7K) per QALY, were 75.9%, 85.1%, and 89.3%, respectively.
CONCLUSIONS: The iCT IRd strategy dominated DRd strategy for NDMM in China by gaining more health benefits and saving costs. The uncertainty of the CUA has limited impact on the cost-effectiveness dominance, supporting the use of iCT IRd strategy as a favorable treatment option.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE351
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Thresholds & Opportunity Cost, Trial-Based Economic Evaluation
Disease
SDC: Oncology