OBJECTIVES

: The measurement of minimal residual disease (MRD) with clonoSEQ®-Assay is being used in the assessment of residual lymphoid B-cell tumor burden throughout treatment with increased accuracy, higher sensitivity and objective assessment compared to traditional cytomorphological approaches. With more targeted therapies and immunotherapies in lymphoid cancers, standardized MRD assessment methods with higher sensitivity and specificity are becoming increasingly important. The primary aim of this analysis is to estimate the cost-effectiveness of MRD testing with clonoSEQ® compared to no MRD testing for patients with multiple myeloma (MM) on maintenance drug therapy in Germany.

METHODS

: The cost impact of clonoSEQ® was analyzed from the German statutory health insurance perspective. Clinical data were derived from literature and expert opinions. Cost input was utilized based on publicly available data and literature. Patients in the MRD arm were assumed to be tested every 6 months. The deterministic Markov model consists of six health states and every patient begins at the start of their drug maintenance therapy. Included therapies are RVD (lenalidomide, bortezomib, dexamethasone), bone marrow transplantation / stem cell transfusion, lenalidomide and for the relapsed health state carfilzomib, lenalidomide and dexamethasone.

RESULTS

: For a time horizon of ten years, the cost impact analysis shows total cost of € 336’056 for patients with MRD testing using the clonoSEQ® in comparison to € 364’576 for simulated patients without an MRD test. The cost savings per patients are calculated to be € 28’520 per patient in Germany. Cost savings after 3 years are 25’224 € per patient. The main drivers for the cost differences are the saved cost of unnecessary drug therapies.

CONCLUSIONS

: Based on the underlying health economic model, the clonoSEQ® MRD test can support health insurance funds in Germany to more efficiently use high cost drugs in the treatment of multiple myeloma.