COST-EFFECTIVENESS OF ELRANATAMAB VERSUS PHYSICIAN’S CHOICE OF TREATMENT FOR TRIPLE-CLASS-EXPOSED MULTIPLE MYELOMA IN JAPAN
Author(s)
Akira Yuasa, PhD1, Mitsuhiro Nagano, MSc1, Yoichi Kamei, MSc2, Kengo Hatsuyama, BS3, Hiroyuki Matsuda, PhD3, Patrick Hlavacek, MPH4, Marco Dibonaventura, PhD4, Kenshi Suzuki, MD, PhD5;
1Pfizer Japan Inc., Japan Access & Value, Tokyo, Japan, 2Pfizer R&D Japan, Tokyo, Japan, 3IQVIA Solutions Japan G.K., Real World Evidence Solutions & HEOR, Tokyo, Japan, 4Pfizer Inc., Global Access & Value, New York, NY, USA, 5Japanese Red Cross Medical Center, Myeloma/AL amyloid unit, Tokyo, Japan
1Pfizer Japan Inc., Japan Access & Value, Tokyo, Japan, 2Pfizer R&D Japan, Tokyo, Japan, 3IQVIA Solutions Japan G.K., Real World Evidence Solutions & HEOR, Tokyo, Japan, 4Pfizer Inc., Global Access & Value, New York, NY, USA, 5Japanese Red Cross Medical Center, Myeloma/AL amyloid unit, Tokyo, Japan
OBJECTIVES: Elranatamab is a bispecific antibody targeting both BCMA and CD3, and is currently available in Japan for the treatment of patients with triple-class-exposed (TCE) multiple myeloma (MM). This study evaluated the cost-effectiveness of elranatamab compared with a mix of currently reimbursed combination therapies selected as physician’s choice of treatment (PCT) for TCE MM in Japan .
METHODS: A partitioned survival model with three health states (progression-free, progressed, death), previously employed in earlier studies, was adapted for the Japanese setting. Efficacy data for elranatamab were derived from 28.4-month follow-up results of the MagnetisMM-3 trial. To estimate comparative efficacy between elranatamab and PCT, an unanchored matching-adjusted indirect comparison was conducted using data from the observational LocoMMotion study. Physician interviews were conducted to inform treatment patterns, costs, and healthcare resource utilization in Japan. The model projected lifetime costs and outcomes over a 25-year time horizon, using weekly cycles and applying a 2% annual discount rate from the Japanese payer perspective. Outcomes included life-years (LYs), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). In addition, sensitivity and scenario analyses were conducted.
RESULTS: Elranatamab was associated with a larger QALYs increase than PCT (2.59 vs. 0.82), resulting in an incremental gain of 1.77 QALYs. Total costs for elranatamab were JPY 24,477,750 (USD 158,053) versus JPY 19,446,094 (USD 125,563) for PCT, resulting in an incremental cost of JPY 5,031,656 (USD 32,425). The corresponding ICER was JPY 2,846,021 (USD 18,377) per QALY gained, which is significantly lower than the commonly accepted willingness-to-pay thresholds (JPY 7,500,000/QALY [USD 50,335 USD/QALY]) in Japan.
CONCLUSIONS: Elranatamab represents a cost-effective treatment option compared to PCT from the Japanese payer perspective. These findings provide valuable evidence to support future decision-making and policy discussions regarding the health economic impact of TCE MM in Japan.
METHODS: A partitioned survival model with three health states (progression-free, progressed, death), previously employed in earlier studies, was adapted for the Japanese setting. Efficacy data for elranatamab were derived from 28.4-month follow-up results of the MagnetisMM-3 trial. To estimate comparative efficacy between elranatamab and PCT, an unanchored matching-adjusted indirect comparison was conducted using data from the observational LocoMMotion study. Physician interviews were conducted to inform treatment patterns, costs, and healthcare resource utilization in Japan. The model projected lifetime costs and outcomes over a 25-year time horizon, using weekly cycles and applying a 2% annual discount rate from the Japanese payer perspective. Outcomes included life-years (LYs), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). In addition, sensitivity and scenario analyses were conducted.
RESULTS: Elranatamab was associated with a larger QALYs increase than PCT (2.59 vs. 0.82), resulting in an incremental gain of 1.77 QALYs. Total costs for elranatamab were JPY 24,477,750 (USD 158,053) versus JPY 19,446,094 (USD 125,563) for PCT, resulting in an incremental cost of JPY 5,031,656 (USD 32,425). The corresponding ICER was JPY 2,846,021 (USD 18,377) per QALY gained, which is significantly lower than the commonly accepted willingness-to-pay thresholds (JPY 7,500,000/QALY [USD 50,335 USD/QALY]) in Japan.
CONCLUSIONS: Elranatamab represents a cost-effective treatment option compared to PCT from the Japanese payer perspective. These findings provide valuable evidence to support future decision-making and policy discussions regarding the health economic impact of TCE MM in Japan.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE354
Topic
Economic Evaluation
Disease
SDC: Oncology, STA: Biologics & Biosimilars