Presentation (CTI)

OBJECTIVES: The objective of this study was to estimate quality-adjusted life years (QALYs) associated with belantamab mafodotin in combination with bortezomib and dexamethasone (BVd) compared with other clinically available treatment options used in routine practice for second-line or later RRMM.
METHODS: A partitioned survival model with four health states (progression-free on treatment, progression-free off treatment, progressed disease, and death) was used to compare BVd with six relevant comparators: bortezomib-dexamethasone (Vd), daratumumab-Vd (DVd), pomalidomide-Vd (PVd), carfilzomib-d (Kd), daratumumab-Kd (DKd), and isatuximab-Kd (IsaKd). Health outcomes were discounted at an annual rate of 5.0%. Clinical efficacy for BVd and DVd was informed by the DREAMM-7 trial, while relative treatment effects for the remaining comparators were derived from a network meta-analysis. Health state utilities were estimated using EQ-5D-3L data from DREAMM-7 and adjusted to reflect age-specific quality of life in the Brazilian population. Survival extrapolations were constrained by age- and sex-adjusted Brazilian general population mortality. Analyses were conducted in the overall intent-to-treat (ITT) population and in lenalidomide-refractory and lenalidomide-exposed subgroups.
RESULTS: Across all evaluated populations, BVd achieved the highest QALYs among all comparators. In the ITT, lenalidomide-refractory, and lenalidomide-exposed populations, BVd yielded 5.7, 4.7, and 4.7 QALYs, respectively. In comparison, QALYs for the remaining treatment options ranged from 3.2 to 4.9 in the ITT population, from 2.6 to 3.6 in the lenalidomide-refractory subgroup, and from 2.2 to 3.8 in the lenalidomide-exposed subgroup.
CONCLUSIONS: BVd consistently yielded the highest QALYs across all evaluated populations, supporting its role as a valuable therapeutic option for the treatment of RRMM in the second line or later in the Brazilian healthcare system.