OBJECTIVES: Current, real-world information on HCRU costs for French patients with MM is limited, especially for patients with heavily pre-treated relapsed/refractory MM (RRMM). This study aimed to quantify the national MM economic burden in France using the SNDS national coverage claims database.

METHODS: This retrospective cohort study used SNDS data for French patients with newly diagnosed MM between 2013 and 2018 who received active treatment within 30 days of diagnosis. There was no minimum time of follow-up specified. HCRU reimbursement costs (annualised using 2019 prices) included hospitalisations, drugs, consultations, procedures, tests, devices, transport and sick leave. Drug treatments, reported by line of therapy (LOT), were algorithmically defined using drug regimen, duration of therapy, and gaps between treatments. Analyses were stratified by stem cell transplant (SCT) status and LOT.

RESULTS: Of 6413 patients included (median age at diagnosis: 69 years; median follow-up: 22 months), 40% received 1 LOT, 28% received 2 LOT, 14% received 3 LOT and 15% received ≥4 LOT (in 3% LOT was undetermined). Average annual hospitalisation was 6.3 episodes/patient/year (median duration: 11.6 days). Total average HCRU annual cost for this cohort during the study period was €58.3K/patient (€28.2K/patient/year drug cost and €22.2K/patient/year hospitalisation cost). Fifty-one percent of overall costs were directly related to treatment administration. Of all costs arising from hospitalisation during follow-up, 72.6% were accrued in the first year following diagnosis. Monthly HCRU cost increased from €4.7K/patient at LOT2 to €9.5K/patient at LOT4+, reflecting increased drug costs at later LOTs. At LOT4+, 39% received daratumumab and 37 distinct regimens were identified. Costs were higher, particularly in the first year, for the 30% of patients who underwent SCT.

CONCLUSIONS: This comprehensive national-level study in France showed the high economic burden related to MM, which increased with subsequent LOTs, and low clinical consensus for LOT4+ treatments.

FUNDING: GlaxoSmithKline (208292).