OBJECTIVES: Our model was conducted from payer perspective to assess the cost-effectiveness of daratumumab triplet therapy (DVd) to carfilzomib doublet regimen (Kd) for patients with Relapsed or Refractory Multiple Myeloma (RRMM) who received at least one prior therapy over time horizon of 20 years.

METHODS: A partitioned survival model including three health states: pre-progression, post-progression, and death was constructed to capture the outcomes, consequences, and costs of the use of daratumumab triplet therapy among RRMM patients who received at least one prior therapy. The cycle length was one week to capture any differences in costs. The clinical evidence for DVd regimen and Kd regimen was extracted from updated CASTOR and ENDEAVOR clinical trials, respectively. All adverse events of both arms that impact patient life was captured from its published clinical trials. The direct medical costs were captured from the health insurance hospitals. The utilities were extracted from published studies. Deterministic and probabilistic sensitivity analyses were conducted.

RESULTS: Over a 20-year time horizon, the difference in quality adjusted life years (QALYs) and life years (LYs) between DVd and Kd was 0.34, 0.43, respectively. The difference in cost between DVd compared to Kd was EGP -1,504,728. Compared to Kd, DVd regimen is less costly and more effective. Thus, DVd is a dominant treatment option over Kd.

CONCLUSIONS: Over time horizon of 20 years from payer perspective in Egypt, reimbursement of DVd regimen is considered to be a cost-saving option compared to Kd regimen as it generates cost savings with improvement of QALYs and LYs.