OBJECTIVES

Multiple myeloma (MM) is a cancer caused by malignant plasma cells, affecting the bone marrow. Globally, nearly 2.1 persons per 100,000 live with MM and an estimated 130,000 new cases occur annually. While previous reviews investigated the economic burden of MM, to date there is no record of published systematic evidence appraisals of the burden specifically in newly diagnosed MM (NDMM) populations.

METHODS

A systematic literature review (SLR) identifying studies (randomized and non-randomized clinical trials) published between 01/2005 and 11/2018 that reported on economic burden (direct/indirect costs, healthcare resource use) of NDMM in adult patients was conducted. The searched electronic databases included Medline/Embase/CEA-Registry/EconLit/Cochrane. Key conference (ASH/EHA/ASCO/ESMO/ISPOR) proceedings and posters were hand-searched. Case reports, non-systematic reviews, editorials/letters and non-English studies were excluded. Two researchers independently screened all studies and performed extraction.

RESULTS

A total of 40 references (38 individual studies) reporting economic outcomes were identified. Of these, 29 studies reported direct cost data (of these, 21 reported treatment-specific direct cost data), while information on resource utilization was covered by 11 studies with 4 studies reporting both cost and resource utilization data. Only one study reported indirect costs (productivity loss).

Published studies presenting direct cost analyses often varied considerably depending on the selection of cost components. For the US, total direct cost associated with NDMM of approximately $11,000-$16,000 per patient/month was reported. Inpatient admissions and adverse events were consistently reported as key cost drivers (20-60%). Regarding specific therapies, the addition of lenalidomide to various treatment regimens was shown to consistently result in a substantial cost increase (>70%). Productivity loss investigated by the one US study was valued at $14,467-$18,329 per patient/per year.

CONCLUSIONS

These findings illustrate the existing economic burden of NDMM. However, more research is necessary for consistent evidence on the societal burden including indirect costs, productivity loss and caregiver burden associated with NDMM.