OBJECTIVES: To assess real-world costs and HCRU of patients with RRMM who are triple-class exposed (TCE) to proteasome inhibitors, immunomodulatory drugs, and anti-CD38 monoclonal antibodies.

METHODS: This was a retrospective analysis utilizing data from the Optum Clinformatics Data Mart database (01 Jan 2010–31 Mar 2022; index dates 2016–2022 post-TCE). Patients were aged ≥18 years and were TCE with ≥1 post-TCE line of therapy (LOT) and ≥3 prior LOT on or before TCE. Assessments included per-patient per-month (PPPM) costs during a LOT post-TCE and until lost to follow-up (LTFU), and PPPM HCRU (hospital, outpatient, emergency room [ER], laboratory stays/visits). Descriptive statistics are reported.

RESULTS: A total of 333 patients with a mean age of 71.9 years were included; 51%, 29%, and 20% had received 3, 4, and 5 LOT, respectively, prior to the index date. Overall mean (SD) PPPM cost was $28,154 ($22,074) during LOT1 (LOT1–LTFU, $30,090 [$25,735]); costs increased at each subsequent LOT to $33,903 ($26,409) during LOT4. MM drugs generally incurred about half the overall cost. Outpatient costs ranged from $6396–$10,171 and were lowest during LOT1 and highest during LOT3. Hospitalization costs ranged from $3799–$7017 and were lowest during LOT4 and highest during LOT3. Mean ER and laboratory costs generally increased at each LOT (ER: $366 during LOT1, $894 during LOT4; laboratory: $923 during LOT1, $2055 during LOT4). During LOT1, mean (SD) number of outpatient visits, hospitalization stays, ER visits, and laboratory visits PPPM were 5.4 (3.38), 0.2 (0.39), 0.2 (0.41), and 2.4 (1.69), respectively; for patients with ≥1 hospitalization, length of stay PPPM was ~3 days. These numbers increased with subsequent LOT.

CONCLUSIONS: Patients with TCE RRMM incur high costs, particularly for MM therapies, that increase with LOT. Hospitalization and outpatient costs also remain high across LOT.